Congressional Record, Volume 153 Issue 167 (Wednesday, October 31, 2007)

[Congressional Record Volume 153, Number 167 (Wednesday, October 31, 2007)]
[Senate]
[Pages S13625-S13641]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Ms. STABENOW (for herself and Mr. Cochran):
S. 2270. A bill to include health centers in the list of entities
eligible for mortgage insurance under the National Housing Act; to the
Committee on Banking, Housing, and Urban Affairs.
Ms. STABENOW. Mr. President, today I am pleased to introduce the
Community Health Center Capital Investment Act. I also thank my
colleague, Senator Thad Cochran of Mississippi, for joining me in
sponsoring this critical legislation. Health centers in both our states
are committed to serving more people, and our legislation will give
them a little help to do just that.
One of our most important investments in our health-care system is

[[Page S13626]]

funding the Community Health Center program. According to the National
Association of Community Health Centers, health centers provide
comprehensive primary and preventive care to over 16 million people--
including nearly 7 million uninsured--each year in more than 6,000
urban and rural communities.
One of my initial pledges when I first ran for the Senate was to
increase the number of community health centers in Michigan. Since I
became a Senator, there are new 15 community health centers or access
points in Michigan. I am also so pleased to have had the support of so
many of my colleagues in increasing funding for community health center
grants. This year, 64 Senators signed the Stabenow-Bond funding
request, and we were pleased that the Senate Labor-HHS-Education
Appropriations bill will provide an additional $250 million increase
for community health centers. This increased funding will help reach
nearly 2 million people next year.
But even as we provide assistance to community health centers for
operations, we cannot forget their capital needs such as renovating
older buildings, purchasing new equipment, and investing in health
information technology. But in general, without specific authorization
in Federal law, health centers cannot use current grant dollars for
construction, modernization, or expansion of facilities.
According to NACHC, one out of three health centers currently
operates in buildings that are 30 years old or older. The average cost
of a facility project is estimated to be $2.3 million. Many centers
borrow funds for these purposes at rates that could be, and should be,
lower.
Kim Sibilsky, the executive director of the Michigan Primary Care
Association, wrote me: ``The majority of Michigan's 34 community Health
Center organizations were founded in the middle and late 1970s, and
many of their 160 community-based sites are located in facilities that
require renovation to meet the changing health care needs of their
communities. More readily available renovation dollars will assist
Michigan Health Centers in improving access to quality health care for
Michigan residents.''
One simple solution would be granting access for community health
centers to use the facility assistance programs at the Department of
Housing and Urban Development. If health centers were able to access
HUD's loan guarantee and mortgage insurance program through the Title
XI Small Medical Group Facilities Program, they would have an important
tool with which to address facility concerns.
The legislation we are introducing today is a small clarification to
the Title XI Program to ensure that health centers can obtain mortgage
insurance under the program. But this small change will have a huge
reward for our safety-net providers. It will allow them to lower the
interest rate on the money they borrow, and therefore lower the cost of
the project for the center. This savings will be translated directly to
increased patient care.
I ask unanimous consent that the letter of support be printed in the
Record.
There being no objection, the material was ordered to be placed in
the Record, as follows:

National Association of

Community Health Centers, Inc.,

October 25, 2007.
Hon. Debbie Stabenow,
Hart Senate Office Building,
Washington, DC
Hon. Thad Cochran,
Dirksen Senate Office Building,
Washington, DC
Dear Senator Stabenow and Senator Cochran: On behalf of the
National Association of Community Health Centers, the
advocate voice for our nation's Community, Migrant, Public
Housing and Homeless Health Centers and the 16 million
patients they serve, I am writing to offer our strong
endorsement of your bipartisan legislation the ``Community
Health Center Capital Investment Act.''
America's Health Centers commend you for your leadership in
introducing this important legislation to expand access to
federal grants for capital improvements in the nation's 1,100
federally qualified health centers. As the health care home
for 16 million people in more than 6,000 urban and rural
locations, health centers provide high quality, comprehensive
primary and preventive care for children and adults. Each
year as the number of patients served at health centers
continues to increase, so will the need for modernization and
construction of new health center facilities.
Your proposal is a significant step forward toward
improving access to primary health care across the country. A
recent survey in twelve states found that nearly two-thirds
of health centers need to expand or modernize their current
buildings, while some areas need to construct new facilities
to treat the growing number of patients in their communities.
Today, health centers have limited access to federal grants
for facility improvements and struggle to raise sufficient
capital to meet the $2.3 million average cost of facility
projects. By ensuring that health centers have access to the
Housing and Urban Department's loan guarantee and mortgage
insurance program through the Title XI Small Medical Group
Facilities Program, health centers will have an important
tool to address these facility concerns.
We greatly applaud your legislation to ensure that the
nation's health centers will be authorized to access HUD's
loan guarantee and mortgage insurance programs for the
construction, modernization and expansion of their
facilities. Your leadership on this issue will significantly
improve the health and well-being of our nation's medically
underserved.
Again, thank you for your sponsorship of the ``Community
Health Center Capital Investment Act.'' America's Health
Centers are proud to endorse your legislation and offer their
active support in helping to secure its enactment.
Sincerely,

Craig A. Kennedy, MPH,

Associate Vice President,
Federal and State Affairs.

Mr. COCHRAN. Mr. President, community health centers provide care for
over 15 million patients nationwide each year and are a critical part
of our country's health care network. Many of these centers operate out
of buildings that are in need of modernization or expansion. Current
law limits access to federal funds to community health centers for any
type of construction, modernization, or expansion. Therefore, the only
funds available to community health centers for facilities are through
congressionally directed spending.
We are introducing a bill today to include community health centers
as eligible recipients for funding through the Department of Housing
and Urban Development's Small Medical Group Facilities Program. Under
this competitive program, community health centers will be able to
access loan guarantees and mortgage insurance, thus giving them a tool
to address their facility concerns and by doing so, better serve their
patients.
I am pleased to offer this legislation that will help improve access
to and quality of community health center care.
______

By Mr. BIDEN (for himself, Mr. Grassley, Mr. Durbin, and Mrs.
Feinstein):
S. 2274. A bill to amend the Controlled Substances Act to prevent the
abuse of dextromethorphan, and for other purposes; to the Committee on
the Judiciary.
Mr. BIDEN. Mr. President, ``Robotripping,'' ingesting large amounts
of cough suppressants containing a common over-the-counter ingredient
called Dextromethorphan, or ``DXM,'' is a dangerous, potentially
lethal, threat to our Nation's children. That is why today I am
introducing the Dextromethorphan Abuse Reduction Act of 2007, which
takes significant steps towards countering this alarming problem.
DXM is a cough suppressing ingredient found in many over-the-counter
products. While DXM is safe at the recommended dosage, it can produce a
hallucinogenic effect similar to that of PCP if ingested in abnormally
high doses. Because many drugs containing DXM are legal and widely
available over-the-counter, too many teens have the perception that
they are not dangerous regardless of the amount ingested. Nothing could
be further from the truth; overdosing on DXM can cause a rapid
heartbeat, high blood pressure, seizures, brain damage, elevated body
temperatures, and even death.
Recent studies reveal troubling rates of DXM abuse. The number of
reported cases in California has increased ten-fold since 1999 and
experts believe that this mirrors national trends. Moreover, the
Partnership for a Drug-Free America estimates that 2.4 million teens--1
in 10--got high on over-the-counter cough medicines in 2005. Children
ages 9 to 17 are the fastest growing group of DXM abusers. Indeed, the
latest Monitoring the Future survey revealed that

[[Page S13627]]

nearly 7 percent--or one in about every 14--12th graders reported
abusing cough or cold medicines to get high during the past year. Mr.
President, these shocking numbers speak for themselves.
To be certain, this is not the first time we have seen the abuse of
over-the-counter medications. As you will recall, we spent much of the
109th Congress debating how to address the dangers posed by
pseudoephedrine, which can be used to manufacture methamphetamine. We
passed the Combat Methamphetamine Epidemic Act of 2005, which took the
important step of moving medications containing pseudoephedrine behind
the counter and closely regulating their sales. While this move was
controversial at the time among those who believed it imposed an
unnecessary inconvenience on law-abiding Americans, it has worked:
domestic manufacture of methamphetamine has been reduced dramatically
and there is no indication that people who legitimately need medicines
containing pseudoephedrine are not receiving them.
My bill takes two key steps to combat the abuse of medicines
containing DXM. First, it regulates bulk DXM--the powder that has not
been combined with any other ingredients--by placing it in Schedule V
of the Controlled Substances Act. Cough medicine with codeine is also a
Schedule V substance. This gives DEA the authority to monitor and
control DXM in its unfinished form. While DXM-containing commercial
end-products like Robitussin and Coricidin Cough and Cold will not be
scheduled, the bill requires that any would-be purchaser of a DXM-
containing product be 18 years of age, a move that many grocery stores
and pharmacies have already voluntarily taken.
Second, and equally important in my view, the bill infuses
substantial funding into efforts to raise public awareness about the
problem of prescription and over-the-counter drug abuse, and it
establishes coordinated efforts to educate teens and parents about
medicine abuse. I have always said that tough enforcement efforts must
be coupled with equally tough prevention and treatment measures.
Prevention is a key component to solving the problem of rising medicine
abuse, and my bill provides robust funding for educational television
advertisements, community awareness and prevention programs, and
targeted grants made available to local community coalitions to develop
comprehensive strategies to reverse the rise in medicine abuse in a
particular community.
Senators Grassley, Durbin, and Feinstein are original cosponsors of
the legislation. The bill is also supported by a number of retail
organizations including the National Association of Chain Drug Stores,
NACDS, the Consumer Healthcare Products Association, CHPA, and the Food
Marketing Institute, FMI. The Community Anti-Drug Coalition of America,
CADCA, and the Partnership for a Drug-Free America also support the
bill.
I would like to thank Senators Grassley, Feinstein, and Durbin for
their support on this and many other important drug issues facing our
country, and I hope all members of this body will join us in this
effort and support this bill.
Mr. GRASSLEY. Mr. President, I am pleased to join my colleague,
Senator Biden, in introducing the Dextromethorphan Abuse Reduction Act
of 2007. As senior members of the U.S. Senate, and as chairman and co-
chairman of the Senate Caucus on International Narcotics Control, we
have seen firsthand how trends in drug abuse have changed over the
years and we have worked to provide effective solutions to the drug
problem whether the matter is foreign or domestic.
Together, we have been monitoring the recent reports in the media and
in the health community detailing new and emerging trends in drug abuse
among teens. The reports have established that the fastest rising area
of drug abuse among teens is the abuse of prescription drugs that are
available in the drug cabinets of parents, family, and friends. These
reports indicate that there is also a trend among teens to abuse
nonprescription cough and cold medicines that are available without a
prescription, over the counter, OTC, at pharmacies and grocery stores
across the country. These trends highlight a new danger to America's
youth as these products are readily available and are often times
perceived to be safe even if used outside their intended use. We cannot
afford to ignore this trend and need to ensure that we are doing all we
can to protect our kids. If we don't address this problem now, the use
of prescription drugs and OTC cough and cold medicines could become
more prevalent than the use of traditional illegal narcotics such as
marijuana, cocaine, heroin, and methamphetamine.
To illustrate this point, the 2006 University of Michigan annual
survey of U.S. adolescents found that while illicit drug use among
teens is down, use and abuse of prescription drugs remains high. This
includes the abuse of powerful painkillers such as OxyContin and
Vicodin. Another survey by the Partnership for a Drug Free America
released just last year also found similar results stating that 1 in 5
teens admitted to abusing prescription drugs.
These surveys also included new questions on nonprescription drugs.
The University of Michigan survey found that nearly 1 in 14 12th grade
students had used nonprescription drugs to get high. The Partnership
for a Drug Free America also found that nearly 10 percent of teens have
abused cold and cough medicines that contain dextromethorphan or DXM,
the active ingredient in OTC cough suppressants. Taken together, these
surveys are further evidence that abuse of both prescription and
nonprescription OTC drugs is more common than abuse of many illicit
drugs. As such, it is our duty to ensure that the laws on the books are
adequate to address the new trends in drug abuse.
Of particular concern to me is the abuse of medicines that are
available OTC because of how prevalent these products are. Further,
many parents may not know about the abuse of such products. For
instance, many parents have never heard of dextromethorphan or DXM and
are unaware that there is a problem with the abuse of this drug. For
those unfamiliar, DXM is the main active ingredient in a number of OTC
products, primarily in cough medicines. DXM is the active ingredient
and is generally available in two forms, a ``finished dosage form'' and
an ``unfinished dosage form''. Finished dosage form means a product
contains DXM and other inactive ingredients that are approved for human
use, such as cough and cold syrups and pills. Unfinished dosage form
refers to the raw chemical DXM in any concentrated amount that is not
in finished dosage form for consumption. Unfinished DXM is generally
not available at local pharmacies and grocery stores; however, it is
available over the Internet and finding its way into our communities.
Because both forms, finished and unfinished, are readily available to
teens, we need to ensure that reasonable controls are put in place to
ensure that access to DXM is limited to those who need the products for
true medicinal purposes.
So why regulate DXM at all? Aside from the increasing number of teens
abusing the product, the potential dangers are cause enough. Abuse of
DXM produces a hallucinogenic effect similar to that of PCP or LSD. To
get this effect, teens must often ingest large quantities of DXM and
given the uncertain dosage to reach this hallucinogenic effect,
overdosing on the product is a real danger. If an overdose occurs, the
effects can include an irregular heartbeat, elevated blood pressure,
seizures, brain damage, and even death. In fact, both the Food and Drug
Administration, FDA, and the Substance Abuse and Mental Health Services
Administration, SAMSHA, have posted warnings about the abuse of DXM in
OTC finished dosage form and the unfinished dosage powdered form that
kids are obtaining over the Internet.
Because of these dangers that abuse and overdose pose, we are here
today introducing legislation that will place reasonable restrictions
on the sale of DXM. The Dextromethorphan Abuse Reduction Act of 2007
strikes the appropriate balance of regulating access to DXM and
products that contain DXM for those under 18 years old while making
sure these products remain available for those who have a legitimate
medical need.
First, our legislation will regulate the sale of unfinished DXM by
placing it on Schedule V of the Controlled Substances Act. This is the
tier of the controlled substances list that currently

[[Page S13628]]

regulates other forms of cough syrup that contains codeine. As a
Schedule V product, DXM will be regulated by the Drug Enforcement
Administration, DEA, and will allow the Attorney General to regulate
the sale of unfinished DXM over the Internet.
Second, the legislation provides civil penalties for retailers who
knowingly or intentionally sell DXM in finished dosage form to an
individual under the age of 18. This requirement will ensure that
stores and retailers sell products containing DXM in a responsible
manner. However, to ensure that retailers are not improperly fined, the
bill contains an affirmative defense for those who are presented false
or fraudulent identification. The bill also provides the Attorney
General the authority to tier the scheduled fines to reduce the
penalties for retailers who provide an effective employee training
program.
Lastly, this legislation provides vital funding to three important
programs for the prevention of abuse of prescription and
nonprescription drugs. The legislation authorizes funding to the
National Youth Anti-Drug Media Campaign for education to children under
age 18 about the dangers of prescription and OTC drug abuse. I have
been an outspoken critic about the National Youth Anti-Drug Media
Campaign's latest efforts; however, there is a clear need for further
education to parents and communities across the country about the
dangers of prescription drug abuse and the abuse of nonprescription
drugs such as DXM. These funds should help provide an immediate impact
in informing parents of the danger that can be found in a medicine
cabinet at home.
This bill also authorizes funding for the Community Anti-Drug
Coalitions of America, CADCA, to provide education to children under 18
about prescription and OTC drug abuse. It also creates a small federal
grant program under SAMHSA at the Department of Health and Human
Services to provide communities across the country funding if they
demonstrate a major prescription or OTC drug problem and have an
effective strategy to deal with that problem.
This legislation is part of an ongoing effort to prevent the abuse of
DXM, along with other nonprescription and prescription drugs. This
legislation is supported by number of groups including the National
Association of Chain Drug Stores, NACDS, the Food Marketing Institute,
FMI, their member organizations, and the Community Anti-Drug Coalitions
of America among others. I urge my colleagues to support this important
legislation and help prevent the abuse of prescription and OTC drugs.
______

By Mrs. FEINSTEIN:
S. 2275. A bill to prohibit the manufacture, sale, or distribution in
commerce of certain children's products and child care articles that
contain phthalates, and for other purposes; to the Committee on
Commerce, Science, and Transportation.
Mrs. FEINSTEIN. Mr. President, I rise to introduce legislation to ban
the use of phthalates in toys.
This legislation will ban the use of six types of phthalates in toys,
which are linked to birth defects. Phthalates are plasticizing
chemicals used in a variety of everyday products, including cosmetics,
nail polish, paint, and shower curtains. Alarmingly, they are used in a
variety of children's toys, such as rubber ducks, teething rings, and
bath toys.
This legislation will ban the manufacture, sale or distributions of
toys and childcare articles that contain more than .1 percent of DEHP,
DBP, or BBP.
It will also ban the manufacture, sale, or distribution of toys and
childcare articles for use by children 3 years old or younger that
contain more than .1 percent of DINP, DIDP, or DnOP.
It clearly states that phthalates cannot be replaced with other
dangerous chemicals identified by the Environmental Protection Agency
as carcinogens, possible carcinogens, or chemicals that cause
reproductive or developmental harm.
Phthalates are used in a variety of PVC, polyvinyl chloride, plastic
products to make them soft and pliable. Phthalates are not chemically
bonded to PVC molecules. When a child places a plastic toy with
phthalates into his or her mouth, these phthalates leach out of the
plastic product and into the child's system.
Phthalates are found in many common children's toys: rubber ducks,
soft bath books, teethers, and even dolls. In 2006, the San Francisco
Chronicle sent 16 common children's toys to a Chicago lab for testing
to see if they exceeded the .1 percent limit proposed in this
legislation. The results should alarm parents everywhere. One teether
contained a phthalate at five times the proposed limit. A rubber duck
sold at Walgreens had 13 times the proposed limit of DEHP, a
carcinogenic phthalate. The face of a popular doll contained double the
proposed phthalate limit.
While the science is still evolving, we know that exposure to
phthalates can cause serious long-term health effects. Phthalates
interfere with the natural functioning of the hormone system, and can
cause reproductive abnormalities, many resulting from low levels of
testosterone.
In 2005, Dr. Shanna Swan of the University of Rochester School of
Medicine found that pregnant women with high levels of phthalates in
their urine were more likely to give birth to boys with a birth defect
that is a key indicator of low testosterone levels.
Men with high phthalate levels have lower sperm counts and damaged
sperm DNA.
Phthalate exposure has also been linked to premature birth and the
early onset of puberty. They may be a factor in some cancers.
Young children, whose bodies are still growing and developing, are
particularly vulnerable when exposed to phthalates in the toys around
them.
In the face of this troubling science, at least 14 other nations have
acted to ban or restrict the use of phthalates in children's products.
Examples include: the European Union's ban, upon which this legislation
is modeled, has been in effect since 2006; the Argentina Ministry of
Health imposed a ban in 1999; and Japan banned toys containing DEHP and
DINP intended to be put in the mouth of children up to the age of 6.
My home State of California recently became the first state to ban
phthalates in toys and other products intended for children. California
parents will now know that the toys they give their children are not
placing them at risk for serious health problems.
It is time for the rest of the country to follow the lead of
California, the European Union, and other nations. Without action, the
U.S. risks becoming a dumping ground for phthalate laden toys that
cannot legally be sold elsewhere. American children deserve better.
Opponents of this ban will argue that we cannot safely replace
phthalates, and that these replacements could place children at an even
greater risk. The experience in the European Union certainly suggests
otherwise.
Facing the phthalate ban, European manufacturers began to develop
alternatives. Danisco, a Danish company, has introduced a phthalate
alternative that has been approved for use in both the U.S. and the
European Union.
Manufacturers have found ways to make safe, phthalate free toys for
European Union children, and there is no reason that they should not do
the same for American children.
There is much we do not know about the chemicals that surround us.
Evidence is demonstrating that phthalates are posing a risk to
children. I strongly believe that products not known to be safe should
not be in the hands and mouths of children.
I urge my colleagues to support this legislation, and to provide all
American children with the same safe toys available in Europe and
California.
Mr. President, I ask unanimous consent that the text of the bill be
printed in the Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:

S. 2275

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Children's Chemical Risk
Reduction Act of 2007''.

SEC. 2. BAN ON CERTAIN PRODUCTS CONTAINING PHTHALATES.

(a) Findings.--Congress finds that--

[[Page S13629]]

(1) phthalates are a class of chemicals used in polyvinyl
chloride (PVC) plastic to improve flexibility and in
cosmetics to bind fragrance to the product and are used in
many products intended for use by young children, including,
teethers, toys, and soft plastic books; and
(2) there is extensive scientific literature reporting the
hormone-disrupting effects of phthalates and substantial
evidence of phthalates found in humans at levels associated
with adverse effects.
(b) Banned Hazardous Substance.--Effective January 1, 2009,
any children's product or child care article that contains a
phthalate shall be treated as a banned hazardous substance
under the Federal Hazardous Substances Act (15 U.S.C. 1261 et
seq.) and the prohibitions contained in section 4 of such Act
shall apply to such product or article.
(c) Prohibition on Use of Certain Alternatives to
Phthalates in Children's Products and Child Care Articles.--
(1) In general.--If a manufacturer modifies a children's
product or child care article that contains a phthalate to
comply with the ban under subsection (b), such manufacturer
shall--
(A) use an alternative to phthalates that is the least
toxic; and
(B) not use any of the prohibited alternatives to
phthalates described in paragraph (2).
(2) Prohibited alternatives to phthalates.--The prohibited
alternatives to phthalates described in this paragraph are
the following:
(A) Carcinogens rated by the Environmental Protection
Agency as Group A, Group B, or Group C carcinogens.
(B) Substances described in the List of Chemicals Evaluated
for Carcinogenic Potential of the Environmental Protection
Agency as follows:
(i) Known to be human carcinogens.
(ii) Likely to be human carcinogens.
(iii) Suggestive of being human carcinogens.
(C) Reproductive toxicants identified by the Environmental
Protection Agency that cause any of the following:
(i) Birth defects.
(ii) Reproductive harm.
(iii) Developmental harm.
(d) Definitions.--As used in this Act--
(1) the term ``children's product'' means a toy or any
other product designed or intended by the manufacturer for
use by a child;
(2) the term ``child care article'' means all products
designed or intended by the manufacturer to facilitate sleep,
relaxation, or the feeding of children, or to help children
with sucking or teething; and
(3) the term ``children's product or child care article
that contains a phthalate'' means--
(A) a children's product or a child care article any part
of which contains any combination of di-(2-ethylhexyl)
phthalate (DEHP), dibutyl phthalate (DBP), or benzyl butyl
phthalate (BBP) in concentrations exceeding 0.1 percent; and
(B) a children's product or a child care article intended
for use by a child less than 3 years of age that--
(i) can be placed in a child's mouth; and
(ii)(I) contains any combination of diisononyl phthalate
(DINP), diisodecyl phthalate (DIDP), or di-n-octyl phthalate
(DnOP), in concentrations exceeding 0.1 percent; or
(II) contains any combination of di-(2-ethylhexyl)
phthalate (DEHP), dibutyl phthalate (DBP), benzyl butyl
phthalate (BBP), diisononyl phthalate (DINP), diisodecyl
phthalate (DIDP), or di-n-octyl phthalate (DnOP), in
concentrations exceeding 0.1 percent.
______

By Mr. DODD (for himself, Mr. Voinovich, and Mr. Warner):
S. 2276. A bill to enhance United States competitiveness in
aeronautics, and for other purposes; to the Committee on Commerce,
Science, and Transportation.
Mr. DODD. Mr. President, I rise today to introduce the Aeronautics
Competitiveness Act of 2007 with my colleagues, Senators Voinovich and
Warner.
Since the Wright brothers first flew at Kill Devil Hills, aeronautics
has been an iconic American industry. The ability to fly is no less
remarkable because it has now become commonplace; and in fact, that a
flight across the country is now routine is a wonder in itself. Very
few advances have had the national and global impact of the progress of
aeronautics, and at the core of those advances has been a robust
tradition of American ingenuity and production.
The challenges in aeronautics continue to shift. The air traffic
control system is under strain, and my colleagues on the Commerce
Committee have worked diligently this year to chart the path for a
complete overhaul of the system. There are environmental pressures the
industry has not faced before, including pressure to reduce greenhouse
gas emissions. At the same time, new sectors of the business, including
light jets, show the potential for astonishing growth. All of these
challenges require significant technology advances, and a significant
investment in research.
We find ourselves at a crossroads. The European Union has written a
report entitled ``European Aeronautics: A Vision for 2020.'' I can
summarize the vision: it is to supplant the U.S. as the global leader
in aeronautics in the next 13 years. Toward that goal, the E.U. is
investing about $860 million per year at today's exchange rates in a
research fund for aeronautics and ``sustainable surface transport.''
With the investments of individual countries, the total research
spending on civil aeronautics is closer to $4.5 billion. In contrast,
this year's budget for NASA aeronautics research will be on the order
of $550 million. Aeronautics is the first ``A'' in NASA, but receives
less than one-thirtieth of the funds.
The aeronautics industry is part of the fabric of American life, and
has the highest trade surplus of any industry, at $52 billion last
year. But U.S. preeminence is far from assured. This is why I am proud
to introduce a bill that will help to ensure the future competitiveness
of U.S. aeronautics. It increases the authorization level for NASA
aeronautics programs by 20 percent per year for the first 2 years, with
a smaller increase in the third year. It creates a more transparent and
inclusive process for stakeholder input into research priorities, and
encourages NASA to take selected technologies farther along from basic
research towards development. And it invests in the workforce by
providing for scholarships for graduate students at NASA and the FAA,
and creating a program modeled on the Independent Research and
Development program.
I believe the future is bright for this vital industry, and I
strongly feel that we should be unwilling to cede leadership to anyone
in this area, no matter how determined they may be. I urge my
colleagues to support this bill to preserve the leading role of U.S.
aeronautics.
______

By Mr. DURBIN (for himself, Mr. Obama, and Mr. Schumer):
S. 2278. A bill to improve the prevention, detection, and treatment
of community and health care-associated infections (CHAI), with a focus
on antibiotic-resistant bacteria; to the Committee on Health,
Education, Labor, and Pensions.
Mr. DURBIN. Mr. President, we have seen an increasing amount of
attention on the growing problem of community and hospital-associated
methicillin-resistant staphylococcus aureus, or MRSA, infections. The
CDC estimates that in 2005 in the U.S., 94,000 people developed an
invasive drug-resistant staph infection. Out of 94,000 infections,
researchers found that more than half were acquired in the health care
system--people who had recently had surgery or were on kidney dialysis,
for example. Nearly 19,000 Americans die, often needlessly, from these
infections every year. This is more than the number of people who died
from HIV/AIDS, homicide, emphysema, or Parkinson's.
The infections impact not only our civilian families but also our
military families. CDC worked with the Army in 2003 to look at an
outbreak of serious infections among soldiers. Between March and
October 2003, they discovered that 145 American soldiers had been
infected with another drug-resistant bacteria, Acinetobacter baumannii-
calcoaceticus complex, or ABC. This outbreak of drug-resistant wound
infections among soldiers in Iraq appears to have come from the U.S.
military hospitals where they were treated, not the battlefield.
Hospitals are taking active steps to identify and control infections,
but keep in mind that about half of the infections that end up being
treated in a hospital were actually picked up in the community. Schools
in Connecticut, Maryland, North Carolina, Ohio, Virginia, and Kentucky
have had to close to help contain the spread of an infection. School
officials in Mississippi, New Hampshire, and Virginia reported student
deaths within the past month from bacteria, while officials in at least
four other States reported cases of students being infected. Most
recently, a 12-year-old in Brooklyn died from a community-aquired staph
infection.

[[Page S13630]]

In the State of Illinois, cases of the drug-resistant staph infection
closed schools in Aurora and Joliet. Other cases were confirmed in the
Indian Prairie School District in the Aurora Naperville area. Two
suburban Catholic elementary schools outside of Chicago were closed for
heavy-duty cleaning after school leaders discovered each of the student
bodies had a case of a drug-resistant staph infection.
States are taking important steps to control staph infection. The
State of Illinois has taken aggressive steps to identify the infection
before it grows out of control. Illinois is the first State to require
testing of all high-risk hospital patients and isolation of those who
carry the bacteria called MRSA. Twenty-two States have passed laws that
will give their residents important information about hospital
infections. Nineteen States have laws that require public reporting of
infection rates.
States are actively pursuing the options that the CDC recommends for
communities and hospitals to help fight the spread of drug-resistant
bugs. It is time for the Federal Government to follow suit.
Today, I introduce the Community and Healthcare Associated Infections
Reduction Act of 2007. This legislation builds on what hospitals are
already doing and what infectious disease experts and Government
agencies agree is critical to reducing the emergence of these
infections.
My colleagues, Senator Obama and Senator Schumer, and I introduced
this bill because we believe we have a national responsibility to
improve the prevention, detection, and treatment of community and
health care-associated infections. To do so, we need to tackle the
problem from all sides.
We need better data to understand the problem at hand. The bill
requires hospitals to report infection rates to the Federal Government,
which we will then use to target high risk areas, identify hospitals
that are doing a good job of controlling infections, and do a better
job of communicating what we know to hospitals and health departments
around the country. With better data, researchers will learn more about
how to treat and, ideally, how to prevent these dangerous infections.
But, reporting is not enough. We need comprehensive infection control
programs. The bill commissions an updated, comprehensive look at best
practices for hospitals on infection control to provide hospitals the
tools they need to best address these infections.
The bill also requires the Secretary to conduct a feasibility study
on the creation of a Federal payment system to acknowledge and reward
hospitals that are preventing these infections. Would this system work
and is it what hospitals need? Hospital workers, doctors, and nurses do
their very best to protect patients from infection. What more can be
done to reward hospitals that are keeping infection rates low?
In addition, the bill addresses the growing impact of these
infections--inside and outside the hospital. A new public health
campaign will increase awareness in the public and educate people about
reducing and preventing infections, especially in schools, locker
rooms, playgrounds--the areas where we know bacteria can thrive.
Finally, the bill calls for greater coordination of and greater
emphasis on research at the Federal level. There are promising
approaches to the control of infectious disease--for example, some
investigators are looking at the use of bacteria-resistant surfaces in
hospitals and other settings.
In a Nation as rich as ours, with the best health care professionals
in the world, we don't expect people to come into a health care setting
with a broken bone and then go home with a dangerous infection. Our
health care system is safe and high quality, and I think we can only
improve on that with a stronger emphasis on prevention, reporting and
research. Our patients need it, our families deserve it, and everyone
of us wants it.
Mr. President, I ask unanimous consent that the text of the bill be
printed in the Record.
There being no objection, the text of the bill was ordered to be
placed in the Record, as follows:

S. 2278

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Community and Healthcare-
Associated Infections Reduction Act of 2007''.

SEC. 2. FINDINGS.

Congress makes the following findings:
(1) Effective antibiotics have transformed the practice of
medicine and saved millions of lives, but the emergence and
spread of antibiotic-resistant bacterial pathogens poses a
significant threat to patient and public health.
(2) Although many antibiotic-resistant infections occur
most frequently among individuals in hospitals and other
healthcare facilities, they also affect otherwise healthy
individuals in the community.
(3) According to the Centers for Disease Control and
Prevention (referred to in this Act as the ``CDC''),
healthcare-associated infections (referred to in this Act as
``HAI'') are one of the top 10 leading causes of death in the
United States.
(4) In American hospitals alone, HAI account for an
estimated 1,700,000 infections and 99,000 associated deaths
each year. In 70 percent of these deaths, the bacteria are
resistant to at least one commonly used antibiotic.
(5) Dr. John Jernigan, Chief of Interventions and
Evaluations at the CDC, estimates that HAI in hospitals
result in up to $27,500,000,000 in additional healthcare
costs annually. The growing problem of antibiotic resistance,
which affects the most common and least expensive antibiotics
first, also shifts utilization toward more expensive
antibiotics.
(6) Methicillin-resistant Staphylococcus aureus (referred
to in this Act as ``MRSA''), one of the most dangerous forms
of antibiotic-resistant staph infections, highlights the
magnitude of the problem. A recent study by the CDC estimates
that nearly 95,000 people became infected with invasive MRSA
in 2005 in the United States, resulting in 19,000 deaths,
more than the number who died from HIV/AIDS, Parkinson's
disease, emphysema, or homicide. A vast majority (85 percent)
of these infections were associated with healthcare
treatment.
(7) MRSA also affects individuals outside the healthcare
setting and in the community. Recent weeks have seen an
increase by health and education officials in reported staph
infection outbreaks, including antibiotic-resistant strains.
These infections have occurred in New York, Kentucky,
Virginia, Maryland, Illinois, Ohio, North Carolina, Florida,
and the District of Columbia.
(8) The problem of antibiotic-resistant infections is not
limited to MRSA. High levels of resistance in enterococci,
Klebsiella pneumonia, Pseudomonas aeruginosa, and E. coli
have also been reported.
(9) Antibiotic-resistant infections have been discovered in
troops coming back from Iraq and Afghanistan. A CDC study
showed that between March and October 2003, 145 United States
service members at military treatment facilities were
infected or colonized with a multidrug-resistant gram-
negative bacterium called Acinetobacter baumannii. The most
likely source of this outbreak was bacteria within deployed
field hospitals.
(10) Despite this significant public health threat,
information on community and healthcare-associated infections
(referred to in this Act as ``CHAI'') is incomplete and
unreliable. Policymakers, healthcare providers, and
individual consumers have little information about hospital
infection rates, making it difficult to diagnose the scope of
the problem and evaluate current infection prevention
efforts, and assess potential remedies.

SEC. 3. DEFINITIONS.

In this Act:
(1) Administrator.--The term ``Administrator'' means the
Administrator of the Centers for Medicare & Medicaid
Services.
(2) AHRQ.--The term ``AHRQ'' means the Agency for
Healthcare Research and Quality.
(3) CHAI.--The term ``CHAI'' means community and
healthcare-associated infections.
(4) Director.--The term ``Director'' means the Director of
the Centers for Disease Control and Prevention, unless
otherwise specifically designated.
(5) HAI.--The term ``HAI'' means healthcare-associated
infections, which are infections that patients acquire during
the course of receiving treatment for other conditions within
a healthcare setting.
(6) Hospital.--The term ``hospital'' means a subsection (d)
hospital (as defined in section 1886(d)(1)(B) of the Social
Security Act (42 U.S.C. 1395ww(d)(1)(B))).
(7) Interagency working group.--The term ``interagency
working group'' means the interagency working group on
community and healthcare-associated infections established
under section 9.
(8) MRSA.--The term ``MRSA'' means Methicillin-resistant
Staphylococcus aureus.
(9) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.

SEC. 4. COMMUNITY AND HEALTHCARE-ASSOCIATED INFECTION CONTROL
PROGRAM.

(a) Establishment of Best Practices Guidelines for
Infection Control.--
(1) In general.--Not later than 90 days after the date of
enactment of this Act, AHRQ in collaboration with CDC shall
develop best-practices guidelines for internal infection
control plans to prevent, detect, control, and treat CHAI at
hospitals.

[[Page S13631]]

(2) Requirements.--In carrying out paragraph (1), AHRQ
shall--
(A) establish a set of best practices with supporting
justification of their appropriateness and effectiveness
based on nationally-recognized or evidence-based standards,
which practices may include--
(i) the establishment of an infection control oversight
committee; and
(ii) the establishment of measures for the prevention,
detection, control, and treatment of CHAI, such as--

(I) staff training and education on CHAI prevention and
control, including the monitoring and strict enforcement of
hand hygiene procedures;
(II) a system to identify, designate, and manage patients
known to be colonized or infected with CHAI, including
diagnostic surveillance processes and policies, procedures
and protocols for staff who may have had potential exposure
to a patient or resident known to be colonized or infected
with a CHAI, and an outreach process for notifying a
receiving healthcare facility of any patient known to be
colonized or infected with CHAI prior to transfer of such
patient within or between facilities;
(III) the development and implementation of an infection
control intervention protocol that may include active
detection and isolation procedures, the alternation of the
physical plan of a hospital, the appropriate use of anti-
microbial agents, and other infection control precautions for
general surveillance of infected or colonized patients;

(B) work in collaboration with other agencies and
organizations whose area of expertise is the identification,
treatment, and prevention of infectious disease;
(C) publish proposed guidelines for internal infection
control plans;
(D) provide for a comment period of not less than 90 days;
and
(E) establish final guidelines, taking into consideration
any comment received under subparagraph (D).
(b) Consultation of Best Practices Guidelines.--The
Administrator shall consult best practices guidelines in
evaluating hospitals infection control plans as a condition
of participation in the Medicare program.
(c) Authorization of Appropriations.--For the purpose of
carrying out this section, there is authorized to be
appropriated such sums as may be necessary for each of fiscal
years 2008 through 2012.

SEC. 5. COLLECTION, REPORTING, AND COMPILATION OF COMMUNITY
AND HEALTHCARE-ASSOCIATED INFECTION DATA.

(a) In General.--Not later than 120 days after the date of
enactment of this Act, hospitals shall report information
about CHAI to the CDC National Healthcare Safety Network
(NHSN), which shall be used by the CDC to develop a national
database of infection rates in hospitals. With respect to
reporting such information, the following shall apply:
(1) Hospitals shall meet data reporting standards as
required by the NHSN, including timeframes, case-finding
techniques, submission formats, infection definitions and
other relevant terms, methodology for surveillance of
infections, risk-adjustment techniques, or other
specifications necessary to render the incoming data valid,
consistent, compatible, and manageable.
(2) Hospitals shall submit data that allows the CDC to
distinguish between--
(A) infections that are present in patients upon their
admission to the hospital;
(B) infections that occur during a patient's hospital stay;
and
(C) infections caused by multiple drug resistant organisms
and nondrug resistant organisms.
(3) The CDC shall have the authority to make such orders,
findings, rules, and regulations as necessary to ensure that
hospitals accurately and timely track and report data.
(b) Consultation.--The CDC shall review and revise NHSN
standards as appropriate, working in consultation with the
Centers for Medicare & Medicaid Services, AHRQ, and national
organizations engaged in healthcare quality measurement and
reporting.
(c) Data Harmonization.--The Director shall work in
collaboration with the Administrator to support the
harmonization of data for purposes of developing a national
database of infections rates in hospitals and other purposes
determined to be appropriate.
(d) Dissemination of Data.--Not later than 1 year after the
date of enactment of this Act, subject to the confidentiality
of patient records, the CDC shall--
(1) make data available to interested researchers;
(2) make data available to interested State Health
Departments;
(3) produce useful and accessible reports for the public to
allow for comparisons of HAI rates across hospitals; and
(4) use data to assist hospitals in evaluating and
formulating best practices strategies to reduce infection
rates.
(e) Privacy of Data.--Notwithstanding any other provision
of Federal, State, or local law, the infection data collected
pursuant to this Act shall be privileged and shall not be--
(1) subject to admission as evidence or other disclosure in
any Federal, State, or local civil or administrative
proceeding; and
(2) subject to use in a State or local disciplinary
proceeding against a hospital or provider.
(f) Authorization of Appropriations.--For the purpose of
carrying out this section, there is authorized to be
appropriated such sums as may be necessary for each of fiscal
years 2008 through 2012.

SEC. 6. QUALITY IMPROVEMENT PAYMENT PROGRAM.

(a) Pay for Performance Initiatives Report.--Not later than
90 days after the date of enactment of this Act, the
Administrator shall submit to Congress a report studying the
feasibility of reducing HAI rates through a Quality
Improvement Payment Program.
(b) Program.--The report under subsection (a) shall
consider such factors as--
(1) patient demographics, such as--
(A) the median income of patients;
(B) percentage of minority patients; and
(C) disease condition;
(2) hospital characteristics, such as--
(A) median income;
(B) population density of the hospital zip code locale;
(C) university affiliation; and
(D) hospital size as indicated by the number of beds; and
(3) other factors as determined to be appropriate by the
Centers for Medicare & Medicaid Services.
(c) Authorization of Appropriations.--For the purpose of
carrying out this section, there is authorized to be
appropriated such sums as may be necessary for each of fiscal
years 2008 through 2012.

SEC. 7. PUBLIC AWARENESS CAMPAIGN.

(a) In General.--The Director shall award grants to States
for the purpose of enabling the States to carry out public
awareness campaigns to provide public education and increase
awareness with respect to the issue of reducing, preventing,
detecting, and controlling CHAI.
(b) Requirements.--To be eligible for a grant under
subsection (a), a State shall provide assurances to the
Secretary that the State campaign to be conducted under the
grant shall--
(1) provide information on the prevention and control of
CHAI, including appropriate antibiotic use, causes and
symptoms, and management, treatment and reduction methods, in
healthcare settings and non-healthcare settings;
(2) provide information to healthcare providers and the
public, including schools, non-profit organizations, and
private-sector entities; and
(3) work with members of the community to promote awareness
and education, including hospitals, school health centers,
schools, local governments, doctors' offices, prisons, jails,
and other public- and private-sector entities.
(c) Authorization of Appropriations.--For the purpose of
carrying out this section, there is authorized to be
appropriated such sums as may be necessary for each of fiscal
years 2008 through 2012.

SEC. 8. EXPANSION AND COORDINATION OF ACTIVITIES OF THE
NATIONAL INSTITUTES OF HEALTH REGARDING
COMMUNITY AND HEALTHCARE-ASSOCIATED INFECTIONS.

(a) Community and Healthcare-Associated Infections
Initiative Through the National Institutes of Health.--
(1) Expansion and intensification of activities.--
(A) In general.--The Director of National Institutes of
Health (referred to in this section as the ``Director''), in
coordination with the directors of the other national
research institutes (as appropriate), may expand and
intensify programs of the National Institutes of Health with
respect to research and related activities concerning CHAI.
(B) Coordination.--The directors referred to in paragraph
(1) may jointly coordinate the programs referred to in such
paragraph and consult with additional Federal officials,
voluntary health associations, medical professional
societies, and private entities, as appropriate.
(2) Planning grants and contracts for innovative research
in chai.--
(A) In general.--In carrying out subsection (a)(1) the
Director may award planning grants or contracts for the
establishment of new research programs, or the enhancement of
existing research programs, that focus on CHAI.
(B) Research.--In awarding planning grants or contracts
under paragraph (1), the Director may give priority to--
(i) collaborative partnerships, which may include academic
institutions, private sector entities, or nonprofit
organizations with a focus on infectious disease science,
medicine, public health, veterinary medicine, or other
discipline impacting or influenced by emerging infectious
diseases;
(ii) research on the most effective copper-based
applications to stem infections in military and civilian
healthcare facilities; and
(iii) research on new rapid diagnostic techniques for
antibiotic-resistant bacteria.
(b) Report.--Not later than 6 months after the date of
enactment of this Act, the Secretary, in collaboration with
the Director, the Commissioner of Food and Drugs, and the
Director of the National Institutes of Health, shall prepare
and submit to the appropriate committees of the Congress a
report that describes the obstacles to anti-infective,
especially antibacterial, drug research and development. Such
report shall--
(1) identify, in concurrence with infectious disease
clinicians and appropriate professional associations, the
infectious pathogens that are (or are likely to become) a
significant threat to public health because of drug
resistance or other factors;
(2) identify those incentives that may already exist
through Federal programs, such as Orphan Product designation,
including an

[[Page S13632]]

explanation of how such programs would apply to infectious
diseases and in particular resistant bacterial infections;
(3) recommend strategies to publicize current incentives
available to encourage anti-infective, especially
antibacterial, drug research and development;
(4) recommend additional regulatory and legislative
solutions to stimulate appropriate anti-infective, especially
antibacterial, drug research and development;
(5) update the progress made in response to the ``Public
Health Action Plan to Combat Antimicrobial Resistance'' to
include a narrative summary of activities in addition to
tables provided in existing progress reports, highlighting
where gaps remain as well as obstacles to future progress;
and
(6) recommend strategies to strengthen the Federal response
to antimicrobial resistance, as outlined in the Action Plan,
in particular additional actions needed to address remaining
gaps or obstacles to progress in implementing the Plan, as
well as Federal funding needs.
(c) Public Information.--The coordinating committee shall
make readily available to the public information concerning
the research, education, and other activities relating to
CHAI, that are conducted or supported by the National
Institutes of Health.
(d) Authorization of Appropriations.--There is authorized
to be appropriated such sums as may be necessary for each of
fiscal years 2008 through 2012 to carry out this section.

SEC. 9. INTERAGENCY WORKING GROUP ON COMMUNITY AND
HEALTHCARE-ASSOCIATED INFECTIONS.

(a) Establishment.--The Secretary, in coordination with the
Administrator, shall establish an interagency working group
on CHAI to consider issues relating to the reduction and
prevention of these infections.
(b) Membership.--The interagency working group shall be
composed of a representative from each Federal agency
(appointed by the head of each such agency) that has
jurisdiction over, or is affected by, CHAI including--
(1) the Centers for Medicare & Medicaid Services;
(2) the Centers for Disease Control and Prevention;
(3) the Health Resources and Services Administration;
(4) the Agency for Healthcare Research and Quality;
(5) the Food and Drug Administration;
(6) the National Institutes of Health;
(7) the Department of Agriculture;
(8) the Department of Defense;
(9) the Department of Veterans Affairs;
(10) the Environmental Protection Agency; and
(11) such other Federal agencies as determined appropriate.
(c) Duties.--The interagency working group shall--
(1) work in collaboration with the Interagency Task Force
on Anti-microbial Resistance;
(2) facilitate communication and partnership on infection
prevention and quality health-related projects and policies;
(3) serve as a centralized mechanism to coordinate a
national effort--
(A) to discuss and evaluate evidence and knowledge on
infection prevention;
(B) to determine the range of effective, feasible, and
comprehensive actions to improve healthcare quality related
to CHAI; and
(C) to examine and better address the growing impact of
CHAI in communities throughout the United States;
(4) coordinate plans to communicate research results
relating to CHAI prevention and control to enable reporting
and outreach activities to produce more useful and timely
information;
(5) consider and determine the feasibility of establishing
an active surveillance program involving other entities (such
as athletic teams or correctional facilities) for the purpose
of identifying those individuals in the community that are
colonized and at risk of susceptibility to and transmission
of bacteria;
(6) develop an appropriate research agenda for Federal
agencies;
(7) develop recommendations regarding evidence-based best
practices, model programs, effective guidelines, and other
strategies for promoting CHAI prevention and control;
(8) monitor Federal progress in meeting specific CHAI
prevention and control promotion goals; and
(9) not later than 2 years after the date of enactment of
this Act, submit to Congress a report that describes the
appropriateness and effectiveness of best practices
guidelines developed by the Centers for Disease Control and
Prevention for infection control plans.
(d) Meetings.--
(1) In general.--The interagency working group shall meet
at least 6 times each year.
(2) Annual conference.--The Secretary shall sponsor an
annual conference on CHAI prevention, detection, and control
to enhance coordination and share best practices in CHAI data
collection, analysis, and reporting.
(e) Authorization of Appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this section.

SEC. 10. GOVERNMENT ACCOUNTABILITY OFFICE REPORT ON COMMUNITY
AND HEALTHCARE-ASSOCIATED INFECTIONS.

Not later than 2 years after the date of enactment of the
Act, the Government Accountability Office shall submit to
Congress a report on the impact of this Act on--
(1) the prevalence of CHAI; and
(2) the quality and availability of data about CHAI.

SEC. 11. PREEMPTION.

Nothing in this Act shall be construed to preempt existing
State laws, except to the extent that such State laws would
result in the establishment of duplicative or conflicting
surveillance or reporting requirements.
______

By Mr. BIDEN (for himself and Mr. Lugar):
S. 2279. A bill to combat international violence against women and
girls; to the Committee on Foreign Relations.
Mr. BIDEN. Mr. President, one in three women worldwide will
experience gender-based violence in her lifetime. In some countries,
that's true for 70 percent of women. No country is immune. From
trafficking of women in Eastern Europe to ``honor'' killings in Jordan
to rape being used as a brutal weapon of war in Darfur and the Congo,
violence against women and girls crosses all borders and affects women
in all social groups, religions and socio-economic classes.
Around the globe, women and girls face domestic violence, rape,
forced or child marriage, so-called ``honor'' killings, dowry-related
murder, human trafficking, and female genital mutilation. The United
Nations estimates that at least 5,000 ``honor'' killings take place
each year around the world and more than 130,000,000 girls and young
women worldwide have been subjected to genital mutilation. A 2006
United Nations Report found that at least 102 member states had no
specific laws on domestic violence. The statistics are staggering.
Not surprisingly, violence against women and girls has a profound
impact on the health and development of countries worldwide. Violence
breeds poverty. It impedes economic development because it can prevent
girls from going to school, or stop women from holding jobs or
inheriting property, or shut down access to critical health care for
themselves and their children. We can't eradicate poverty and disease
unless we prevent and respond to the violence women face in their own
homes and communities. We cannot truly empower women to become active
in civic life and promote peace, prosperity and democracy unless they
personally are free from fear of violence.
Violence against women is a global health crisis, not just because so
many women and girls are injured and die as a result, but also because
inequality and violence interfere with current efforts to combat the
HIV/AIDS pandemic. Forced sex increases vulnerability to HIV/AIDS
transmission, in part, because condoms are not likely to be used. In
sub-Saharan Africa alone, women account for close to three-quarters of
those living with HIV/AIDS between the ages 18 and 24.
The picture is grim, and can be discouraging. But the good news is
that local and international organizations are working in communities
around the world with courage, sensitivity and great success to help
women overcome violence at home, in school and at work. But they need
our help.
We've made tremendous progress in reducing violence against women
here in the United States since we passed the Violence Against Women
Act, VAWA, in 1994. That important work continues. But we cannot ignore
the devastation wrought by violence in every corner of the globe. Now
is the time to turn our attention to women in other parts of the
world--women whose lives are devastated by poverty, political and civic
exclusion, disease, and violence. Gender-based violence contributes to
the poverty, inequality and instability that threaten peace. Addressing
it isn't just moral; it is also smart.
So today, during this final week of Domestic Violence Awareness
Month, I am introducing with my good friend from Indiana, Senator
Lugar, the International Violence Against Women Act. This
groundbreaking, bipartisan legislation would integrate efforts to end
gender-based violence into all existing, appropriate U.S. foreign
assistance programs.
The International Violence Against Women Act has three main
components. First, the bill reorganizes and rejuvenates the gender-
related efforts of the State Department by creating one central
office--the ``Office for

[[Page S13633]]

Women's Global Initiatives'', directed by a Senate-confirmed Ambassador
who reports directly to the Secretary. The Coordinator of the Office or
Women's Global Initiatives, the ``Coordinator'', will be charged with
monitoring, coordinating, and organizing all U.S. resources, programs
and aid abroad that deals with women's issues, including gender-based
violence. Additionally, my bill creates a new Office of Women's Global
Development at the United States Agency for International Development,
also to be directed by a Senate-confirmed nominee. The Director will be
responsible for addressing gender-based violence and integrating gender
into U.S. government assistance programs. The Director will work
closely with the Coordinator and the Secretary of State to implement
the provisions of the IVAWA legislation.
Under the current organizational scheme, projects addressing violence
against women, either primarily or tangentially, are spread throughout
the State Department and USAID without a central inventory, game plan
or leader. My bill will raise the profile of women's issues generally
at the State Department, and ensure that gender-based violence programs
are building on past successes, leveraging core competencies and
working in conjunction with other initiatives.
Second, the International Violence Against Women Act mandates
creation of a 5-year, comprehensive strategy, with coordinated
programming, to prevent and respond to violence against women in 10 to
20 targeted countries. The act creates a dedicated funding stream of
$175 million a year to support programs dealing with violence against
women in five areas: the criminal and civil justice system--everything
from drafting laws on domestic violence, to enhancing women's access to
property and inheritance rights, to reforming police practices--health
care, girls' access to education and school safety, women's access to
employment and financial resources, and public awareness campaigns that
change social norms.
I know from my experience in Delaware that coordinating community
responses in towns and cities has made all the difference in fighting
domestic violence and rape. I applied those same principles of
coordination and joint programming to the International Violence
Against Women Act. International experts agree on the necessity of a
multi-disciplinary approach that brings governments and nongovernmental
organizations to the table to create sustainable infrastructure. To be
clear, the International Violence Against Women Act is not asking
countries to reinvent the wheel. At every step our strategy will lead
to coordination of efforts to have the greatest possible impact. This
type of effective, cost-efficient, gender-based violence programming
already exists and is taking place in pockets all around the globe. We
have the blueprints; my Act would provide the momentum and support for
a full-scale international priority.
Finally, as the recent reports from the Congo make tragically clear,
in situations of humanitarian crises, conflict and post-conflict
operations, women and girls are vulnerable to horrific acts of
violence. Reports of refugee women being raped while collecting
firewood, soldiers sexually abusing girls in exchange for token food
items, or women subjected to unimaginable brutality and torture as a
tactic of war are shocking in number and inhumanity. The Act requires
training, reporting mechanisms and other measures for those who are
working directly with or protecting refugees and other vulnerable
populations. The act also requires that the State Department identify
``critical outbreaks'' in which violence against women and girls is
being used as a weapon of intimidation and abuse in armed conflict or
war, or is escalating in an environment of impunity, and to take
emergency measures to respond to the outbreaks.
The issue of violence against women and girls is complex and our
legislation is a bold and ambitious plan. There are limitations on the
United States' power to ``fix'' a problem that is so widespread. We are
mindful that no country has a perfect record or all the answers. Yet
Congress has a long and proud history of tackling complex international
problems, most recently the devastating epidemic of HIV/AIDS and the
insidious crime of human trafficking.
I did not approach this legislation lightly. Over the past months,
I've solicited information from every relevant office in the State
Department, USAID and the Department of Justice that works on the
issues of women's rights and gender-based violence abroad. I asked for
input and information from the United Nations secretariat, and many of
its subsidiary agencies who are working to prevent and respond to
gender-based violence internationally in various capacities. And most
importantly, the International Violence Against Women Act was drafted
with the insight and expertise of over 100 nongovernmental
organizations and 40 women's groups around the globe, including
American Refugee Committee, Amnesty International, CARE,
Christian Children's Fund, Family Violence Prevention Fund, Global AIDS
Alliance, Human Rights Watch, Inter-Agency Gender Working Group, IGWAG,
International Rescue Committee, International Justice Mission, Women's
Edge Coalition, Vital Voices Global Partnership and many others. I
thank all of them for their invaluable assistance and perseverance as
this bill came together.

Former United Nations Secretary-General Kofi Annan said ``Violence
against women is perhaps the most shameful human rights violation. And
it is perhaps the most pervasive. It knows no boundaries of geography,
culture or wealth. As long as it continues, we cannot claim to be
making real progress towards equity, development and peace.'' I could
not agree more. My International Violence Against Women Act marshals
together, for the first time, coordinated American resources, good will
and leadership to address this global issue. I believe the time is now
for the U.S. to get actively engaged in the fight for women's lives and
girls' futures.
Over the past 30 years, the understanding of human rights and
violence against women has metamorphosed. A State's responsibility to
protect women from violence has evolved--what was once seen largely as
a private, family or cultural matter is now understood by the
international community as a violation of basic human rights. Violence
against women is a legal wrong. It cannot be excused or justified or
ignored. It is an engrained social norm but one that we can dismantle
over time--one woman at a time--with patience, creativity and sustained
political will. The International Violence Against Women Act is the
first step.
Mr. President, I ask unanimous consent that the text of the bill and
a section-by-section analysis be printed in the Record.
There being no objection, the material was ordered to be placed in
the Record, as follows:

S. 2279

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the
``International Violence Against Women Act of 2007''.
(b) Table of Contents.--The table of contents for this Act
is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Statement of policy.
Sec. 4. Definitions.

TITLE I--COORDINATION AND POLICY PLANNING

Sec. 101. Official positions and institutional changes.
Sec. 102. Policy and programs.
Sec. 103. Inclusion of information on violence against women and girls
in human rights reports.

TITLE II--OTHER PROVISIONS

Sec. 201. Amendments to Foreign Service Act of 1980.
Sec. 202. Support for multilateral efforts to end violence against
women and girls.

SEC. 2. FINDINGS.

Congress makes the following findings:
(1) Violence against women and girls is rooted in multiple
causes and takes many forms, including physical, sexual, and
psychological. It affects all countries, social groups,
ethnicities, religions, and socioeconomic classes and is a
global health, economic development, and human rights problem
of epidemic proportions.
(2) According to the World Health Organization--
(A) approximately 1 in 3 of the women in the world will
experience violence in her lifetime, with rates of up to 70
percent in some countries; and

[[Page S13634]]

(B) 1 in 5 of the women in the world will be the victim of
rape or attempted rape in her lifetime.
(3) According to the 2006 United Nations Secretary-
General's report entitled Ending Violence Against Women, 102
member states have no specific laws on domestic violence.
(4) Women and girls face many different types of gender-
based violence, including forced or child marriage, so-called
``honor killings'', dowry-related murder, human trafficking,
and female genital mutilation. The United Nations estimates
that at least 5,000 so-called ``honor killings'' take place
each year around the world and that more than 130,000,000
girls and young women worldwide have been subjected to female
genital mutilation.
(5) The President's Emergency Plan for AIDS Relief 2006
Report on Gender-Based Violence and HIV/AIDS reports that
violence against women is a public health and development
problem that significantly increases susceptibility to HIV/
AIDS. A United Nations study on the global AIDS epidemic
found that in sub-Saharan Africa, women who are 15 to 24
years old can be infected at rates that are up to 6 times
higher than men of the same age.
(6) Recent studies in Africa indicate that between 16 and
47 percent of girls in primary and secondary school report
sexual abuse or harassment by male teachers or classmates.
Girls who experience sexual violence at school are also more
likely to experience unintended pregnancies or become
infected with sexually transmitted infections, including HIV/
AIDS.
(7) Rape and sexual assault are weapons of war used to
torture, intimidate, and terrorize women and communities.
Amnesty International reports that women have suffered from
sexual violence during conflicts in Rwanda, the former
Yugoslavia, Sierra Leone, and most recently in the Democratic
Republic of the Congo, where women have suffered from brutal
and systematic sexual assaults.
(8) Displaced, refugee, and stateless women and girls in
humanitarian emergencies, conflict settings, and natural
disasters face extreme violence and threats because of power
inequities, including being forced to exchange sex for food
and humanitarian supplies, and being at increased risk of
rape, sexual exploitation, and abuse.
(9) According to the United States Agency for International
Development (USAID)--
(A) 70 percent of the 1,300,000,000 people living in
poverty in the world are women and children;
(B) \2/3\ of the 876,000,000 illiterate adults in the world
are women;
(C) \2/3\ of the 125,000,000 school-aged children who are
not in school are girls;
(D) more than \3/4\ of the 27,000,000 refugees in the world
are women and children; and
(E) 1,600 women die unnecessarily every day during
pregnancy and childbirth.
(10) In 2003, the United Nations Special Rapporteur on
Violence Against Women concluded that violence against women
violates the basic human rights of women, results in
``devastating consequences for women who experience it,
traumatic impact on those who witness it, de-legitimization
of States that fail to prevent it and the impoverishment of
entire societies that tolerate it.''.
(11) Violence against women is an impediment to the health,
opportunity, and development of women and their societies.
According to an October 2006 study of the United Nations
Secretary General entitled Ending Violence Against Women,
``Violence against women impoverishes women, their families,
communities and nations. It lowers economic production,
drains resources from public services and employers, and
reduces human capital formation.''.
(12) The World Bank recognizes that women's health,
education, and economic opportunities directly impact the
development and well being of their families and their
societies. A 2001 World Bank Report, entitled Engendering
Development, reports that greater gender equality leads to
improved nutrition, lower child mortality, less government
corruption, higher productivity, and reduced HIV infection
rates.
(13) Increased access to economic opportunities is crucial
to the prevention of and response to domestic and sexual
violence. Both microfinance-based interventions and increased
asset control have been shown to reduce levels of intimate
partner violence in addition to providing economic
independence for survivors.
(14) Campaigns to change social norms, including community
organizing, media campaigns, and efforts to engage and
educate men and boys, have been shown to change attitudes
that condone and tolerate violence against women and girls
and reduce violence and abuse.

SEC. 3. STATEMENT OF POLICY.

It is the policy of the United States--
(1) to promote women's political, economic, educational,
social, cultural, civil, and human rights and opportunities
throughout the world;
(2) to condemn and combat violence against women and girls,
and to promote and assist other governments in preventing and
responding to such violence;
(3) to promote ending violence against women and girls
around the world, whether the abuse is committed directly by
a foreign government, is implicitly committed by such
government through hostile laws or de jure mandates to
disenfranchise women, or is committed by private actors and
the government fails to address the abuse;
(4) to encourage foreign governments to enact and implement
effective legal reform to combat violence against women and
girls, and to encourage access to justice, true
accountability for abusers, and meaningful redress and
support for victims;
(5) to systematically integrate and coordinate efforts to
prevent and respond to violence against women and girls into
United States foreign policy and foreign assistance programs,
and to expand implementation of effective practices and
programs;
(6) to fully implement the comprehensive international
strategy set forth in section 300G of the Foreign Assistance
Act of 1961, as added by this Act, which provides assistance
to eligible countries to reduce and prevent gender-based
violence with coordinated efforts in the criminal justice,
health, education, and economic sectors;
(7) to support and build capacity of indigenous
nongovernmental organizations that are working to prevent and
respond to violence against women and girls, particularly
women's nongovernmental organizations, and to support and
encourage United States organizations working in partnership
with such nongovernmental organizations;
(8) to prevent and respond to violence against women and
girls through multisectoral methods, working at individual,
family, community, local, national, and international levels
and incorporating service, prevention, training, and advocacy
activities and economic, education, health, legal, and
protective intervention services;
(9) to coordinate activities with recipient country
governments, as appropriate, and with other bilateral,
multilateral, nongovernmental, and private sector actors
active in the relevant sector and country;
(10) to foster international and regional cooperation with
an aim towards defining regional strategies, as appropriate,
for preventing and responding to violence against women and
girls, and exchanging data and successful strategies;
(11) to work through international organizations of which
the United States is a member, including the United Nations
and its specialized agencies, funds and programs to
encourage, promote, and advocate for stronger efforts and
policies to prevent and end violence against women and girls;
(12) to enhance training and other programs to prevent and
respond to violence against women and girls in humanitarian
relief, conflict, and post-conflict operations;
(13) to enhance training by United States personnel of
professional foreign military and police forces and judicial
officials to include specific and thorough instruction on
preventing and responding to violence against women and
girls;
(14) to press for the implementation of policies and
practices in global peace and security efforts, including
United Nations peacekeeping and policing operations, that
prevent and respond to violence against women and girls and
hold personnel accountable for the full implementation of
these policies and practices.

SEC. 4. DEFINITIONS.

In this Act:
(1) Violence against women and girls.--The term ``violence
against women and girls''--
(A) means any act of gender-based violence against women or
girls committed because of their gender that results in, or
is likely to result in, physical, sexual, or psychological
harm or suffering to women, including threats of such acts,
coercion, or arbitrary deprivations of liberty, whether
occurring in public or private life; and
(B) includes--
(i) physical, sexual, and psychological violence occurring
in the family, including battering, sexual abuse of female
children in the household, dowry-related violence, marital
rape, female genital mutilation and other traditional
practices harmful to women, nonspousal violence, and violence
related to exploitation;
(ii) physical, sexual, and psychological violence occurring
within the general community, including rape, sexual abuse,
sexual harassment and intimidation at work, in educational
institutions and elsewhere, trafficking in women, and forced
prostitution; and
(iii) physical, sexual, and psychological violence
perpetrated or condoned by the state, wherever it occurs.
(2) Eligible countries.--The term ``eligible countries''
means countries that are not classified as high-income
countries in the most recent edition of the World Development
Report for Reconstruction and Development published by the
International Bank for Reconstruction and Development.

TITLE I--COORDINATION AND POLICY PLANNING

SEC. 101. OFFICIAL POSITIONS AND INSTITUTIONAL CHANGES.

Chapter 2 of part I of the Foreign Assistance Act of 1961
(22 U.S.C. 2166 et seq.) is amended by adding at the end the
following:

``TITLE XIII--INTERNATIONAL PREVENTION OF VIOLENCE AGAINST WOMEN AND
GIRLS

``SEC. 300A. VIOLENCE AGAINST WOMEN AND GIRLS DEFINED.

``In this title, the term `violence against women and
girls' has the meaning given that term in section 5 of the
International Violence Against Women Act of 2007.

[[Page S13635]]

``Subtitle A--Official Positions and Institutional Changes

``SEC. 300B. OFFICE OF WOMEN'S GLOBAL INITIATIVES.

``(a) Establishment.--There is established in the Office of
the Secretary of State in the Department of State, the Office
of Women's Global Initiatives. The office shall be headed by
the Coordinator of the Office of Women's Global Initiatives
(referred to in this title as the `Coordinator'), who shall
be appointed by the President, by and with the advice and
consent of the Senate. The Coordinator shall report directly
to the Secretary and shall have the rank and status of
Ambassador at Large.
``(b) Purpose.--The Office of Women's Global Initiatives
shall be the sole office coordinating all efforts of the
United States Government regarding international women's
issues and is intended to replace the Office of International
Women's Issues in the Office of the Under Secretary for
Democracy and Global Affairs in the Department of State.
``(c) Duties.--The Coordinator shall have the following
responsibilities:
``(1) In general.--The Coordinator shall--
``(A) design, oversee, and coordinate activities and
programs of the United States Government relating to
international women's issues; and
``(B) direct United States Government resources to--
``(i) prevent and respond to violence against women and
girls throughout the world; and
``(ii) develop the comprehensive international strategy
described in section 300G to reduce violence against women
and girls.
``(2) Principal advisor.--The Coordinator shall serve as
the principal advisor to the Secretary of State regarding
foreign policy matters relating to women, including violence
against women and girls.
``(3) Coordinating role.--The Coordinator shall--
``(A) oversee and coordinate all resources and activities
of the United State Government to combat violence against
women and girls internationally, including developing
strategies for the integration of efforts to prevent and
respond to gender-based violence into United States
assistance programs;
``(B) coordinate all policies, programs, and funding
related to violence against women and girls internationally
of the Department of State, including--
``(i) the Bureau of Population, Refugees, and Migration;
``(ii) the Bureau of Democracy, Human Rights, and Labor;
``(iii) the Bureau for International Narcotics and Law
Enforcement Affairs;
``(iv) the Bureau of Education and Cultural Affairs;
``(v) the Bureau of Political Military Affairs;
``(vi) the Bureau of International Organizations Affairs;
``(vii) the Bureau of Economic and Business Affairs;
``(viii) the Foreign Service Institute;
``(ix) the Office of the Coordinator for Reconstruction and
Stabilization;
``(x) the Office to Monitor and Combat Trafficking in
Persons;
``(xi) the Office of the United States Global AIDS
Coordinator; and
``(xii) all regional bureaus and offices;
``(C) coordinate all policies, programs, and funding
related to violence against women and girls internationally
in the Department of Justice, the Department of Labor, the
Department of Health and Human Services, the Department of
Defense, and the Department of Homeland Security;
``(D) coordinate all policies, programs, and funding
relating to violence against women and girls internationally
in the United States Agency for International Development
(USAID), including the Women's Global Development Office;
``(E) monitor and evaluate all such gender-based violence
programs administered by the entities listed in subparagraphs
(B) through (D), as necessary;
``(F) coordinate all policies, programs, and funding of the
Millennium Challenge Corporation relating to violence against
women and girls internationally;
``(G) design, integrate, and, as appropriate, implement
policies, programs, and activities related to women's health,
education, economic development, legal reform, social norm
changes, women's human rights, and protection of women in
humanitarian crises, including those identified pursuant to
section 300G(c); and
``(H) encourage departments listed in subparagraph (C) to
create agency-specific programmatic guidelines on addressing
violence against women and girls internationally and monitor
implementation of those guidelines.
``(4) Diplomatic representation.--Subject to the direction
of the President and the Secretary of State, the Coordinator
is authorized to represent the United States in matters
relevant to violence against women and girls internationally
in--
``(A) contacts with foreign governments, nongovernmental
organizations, the United Nations and its specialized
agencies, and other international organizations of which the
United States is a member; and
``(B) multilateral conferences and meetings relevant to
violence against women and girls.
``(d) Authorization of Appropriations.--There is authorized
to be appropriated $10,000,000 for each of fiscal years 2008
through 2012, under the heading `Diplomatic and Consular
Programs', to carry out activities under this section. Funds
appropriated pursuant to this subsection shall be under the
direct control of the Coordinator.

``SEC. 300C. WOMEN'S GLOBAL DEVELOPMENT OFFICE.

``(a) Establishment.--There is established, within the
United States Agency for International Development, the
Office of Women's Global Development. The Office of Women's
Global Development shall be headed by the Director of Women's
Global Development (referred to in this title as the
`Director'), who shall be appointed by the President, by and
with the advice and consent of the Senate. The Director shall
report directly to the Administrator of the United States
Agency for International Development and shall consult
regularly with the Coordinator of the Office of Women's
Global Initiatives.
``(b) Purpose.--The Office of Women's Global Development
shall be the sole office coordinating all efforts of the
United States Agency for International Development (USAID)
regarding international women's issues and is intended to
replace the Office of Women in Development in USAID in
existence on the date of the enactment of this title.
``(c) Duties.--
``(1) In general.--The Director shall--
``(A) integrate gender into all policies, programs, and
activities of the United States Agency for International
Development to improve the status of women, increase
opportunities for women, and support the overall development
goals of United States programs and assistance;
``(B) ensure that efforts to prevent and respond to
violence against women and girls are integrated into United
States Government foreign assistance programs at the
strategic planning and country operational plan levels; and
``(C) monitor the manner in which such activities are
integrated, programmed, and implemented in each country plan.
``(d) Authorization of Appropriations.--There is authorized
to be appropriated $15,000,000 for each of fiscal years 2008
through 2012 to carry out activities and collaboration
related to preventing and responding to gender-based
violence. Funds appropriated pursuant to this subsection
shall be under the direct control of the Director. Such funds
are in addition to amounts otherwise available for such
purposes.

``SEC. 300D. ADVISORY COMMISSION ON INTERNATIONAL VIOLENCE
AGAINST WOMEN.

``(a) Establishment.--There is established within the
Department of State an Advisory Commission on International
Violence Against Women (in this section referred to as the
`Advisory Commission').
``(b) Membership.--
``(1) Appointment.--The Advisory Commission shall be
composed of--
``(A) the Coordinator of Women's Global Initiatives, who
shall serve as chair, and the Director of the Women's Global
Development Office, both of whom shall serve ex officio as
nonvoting members of the Advisory Commission;
``(B) 8 members appointed by the Secretary of State who are
not officers or employees of the Federal Government;
``(C) 3 members appointed by the President pro tempore of
the Senate on the joint recommendation of the Majority and
Minority Leaders of the Senate; and
``(D) 3 members appointed by the Speaker of the House of
Representatives on the joint recommendation of the Majority
and Minority Leaders of the House of Representatives.
``(2) Selection.--Members of the Advisory Commission shall
be selected from among--
``(A) distinguished individuals noted for their knowledge
and experience in fields relevant to the issue of
international violence against women and girls, including
foreign affairs, human rights, and international law;
``(B) representatives of nongovernmental organizations and
other institutions having knowledge and expertise related to
violence against women and girls; and
``(C) academics representative of the various scholarly
approaches to the issue of international violence against
women and girls.
``(3) Time of appointment.--The appointments required under
paragraph (1) shall be made not later than 120 days after the
date of the enactment of this title.
``(4) Terms.--The term of each member appointed to the
Advisory Commission shall be 3 years. Members shall be
eligible for reappointment to a second term.
``(c) Duties.--The Advisory Commission shall--
``(1) annually make recommendations to the Secretary of
State regarding best practices to prevent and respond to
violence against women and girls internationally and the
effective integration of such practices into the foreign
policy of the United States, including assistance
programming; and
``(2) consult with members of the United States Government
and with private groups and individuals on the prevention and
response to international violence against women and girls.
``(d) Hearings.--In carrying out this section, the Advisory
Commission may conduct such hearings, sit and at such times
and places, take such testimony, and receive such evidence,
as the Advisory Commission considers appropriate.
``(e) Funding.--Members of the Advisory Commission shall be
allowed travel expenses, including per diem in lieu of
subsistence at rates authorized for employees of agencies

[[Page S13636]]

under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of
business in the performance of duties for the Advisory
Commission.
``(f) Report of the Advisory Commission.--Not later than
May 1 of each year, the Advisory Commission shall submit a
report to the President, the Secretary of State, the
Committee on Foreign Relations of the Senate, and the
Committee on Foreign Affairs of the House of Representatives
that sets forth its findings and recommendations for United
States policy and programs.
``(g) Authorization of Appropriations.--There is authorized
to be appropriated $300,000 for each of the fiscal years 2008
through 2012 to carry out this section.''.

SEC. 102. POLICY AND PROGRAMS.

Chapter 2 of part I of the Foreign Assistance Act of 1961
(22 U.S.C. 2166 et seq.), as amended by section 101, is
further amended by adding at the end the following:

``Subtitle B--Policy and Programs

``SEC. 300G. COMPREHENSIVE INTERNATIONAL STRATEGY TO REDUCE
AND PREVENT VIOLENCE AGAINST WOMEN AND GIRLS.

``(a) Development and Implementation of Strategy.--Not
later than 1 year after the date of the enactment of this
title, the President, with the assistance of the Coordinator
of Women's Global Initiatives and Director of Women's Global
Development, shall develop and commence implementation of a
comprehensive, 5-year international strategy to prevent and
respond to violence against women and girls internationally,
and shall submit it to the Committee on Foreign Relations of
the Senate and the Committee on Foreign Affairs of the House
of Representatives.
``(b) Collaboration.--In developing the strategy under
subsection (a), the President, with the assistance of the
Coordinator, shall consult with--
``(1) the Secretary of State, including the offices and
bureaus listed in section 300B(b)(3)(B), other executive
agencies listed in section 300B(b)(3)(C), United States aid
agencies and offices as listed in section 300B(b)(3)(D), the
Millennium Challenge Corporation listed in section
300B(b)(3)(E), and Interagency Task Force to Monitor and
Combat Trafficking; and
``(2) nongovernmental organizations with demonstrated
expertise working on violence against women and girls,
women's health, or women's empowerment issues
internationally.
``(c) Content.--The strategy developed under subsection (a)
shall--
``(1) identify between 10 and 20 eligible countries that
are geographically, ethnically, and culturally diverse, and
have severe levels of violence against women and girls;
``(2) describe the nature and extent of violence against
women and girls in each country;
``(3) identify how and to what extent the violence against
women and girls in each country is negatively affecting goals
of improving the health, education, economic, democracy and
civic participation, criminal justice, and internally
displaced persons and refugee management sectors in such
country and its region;
``(4) assess the efforts of the government in each country
to prevent and respond to violence against women and girls
and assess the potential capacity of each country to manage 2
or more of the gender violence-based program activities
identified under subsection (d);
``(5)(A) describe the programs to be undertaken in
cooperation with the governments of each country in specific
areas for progress in preventing and responding to violence
against women and girls;
``(B) identify resources to help implement programs; and
``(C) encourage development of national action plans;
``(6) for each country, identify 2 or more of the program
activities listed in subsection (d) and describe how the
selected programs will prevent and respond to the problem of
violence against women and girls, including--
``(A) increasing legal and judicial protections;
``(B) enhancing the capacity of the health sector to
respond to such violence;
``(C) increasing opportunities for women and girls in
education and economic development; or
``(D) promoting societal awareness and changing social
norms;
``(7) include, as appropriate, strategies designed to
accommodate the needs of stateless, internally displaced,
refugee, or religious or ethnic minority women and girls;
``(8) project general levels of resources needed on an
annual basis to achieve the stated objective in each country,
taking into account activities and funding provided by other
donor country governments and other multilateral institutions
and leveraging private sector resources;
``(9) include potential coordination with existing
programs, initiatives, and expertise on preventing and
responding to violence against women and girls that exist
within nongovernmental organizations, including in-country,
civil society organizations, particularly women's
organizations and community-based groups;
``(10) identify the Federal departments and agencies
involved in the execution of the relevant program activities;
and
``(11) describe the monitoring and evaluation mechanisms
established for each country and how they will be used to
assess overall progress in preventing and responding to
violence against women and girls.
``(d) Program Activities Supported.--Assistance provided
under this section shall be used to carry out, in each of the
countries identified in the strategy required pursuant to
subsection (a), 2 or more of the following program
activities:
``(1) Increasing legal and judicial protections by--
``(A) supporting programs that strengthen a coordinated
community response to violence against women and girls,
including through coordination between judges, police,
prosecutors, and legal advocates to enhance prospects for
perpetrator accountability;
``(B) supporting efforts and providing resources to provide
training and technical assistance to police, prosecutors,
forensic physicians, lawyers, corrections officers, judges,
and judicial officials, and where appropriate, to nonlawyer
advocates and traditional community authorities on violence
against women and girls;
``(C) supporting efforts to reform and revise criminal and
civil laws to prohibit violence against women and girls and
create accountability for perpetrators;
``(D) enhancing the capacity of the justice sector,
including keeping official records of all complaints,
collecting and safeguarding evidence, systematizing and
tracking data on cases of violence against women and girls,
and undertaking investigations and evidence gathering
expeditiously;
``(E) helping women and girls who are victims of violence
gain access to the justice sector and supporting them
throughout the legal process, including establishing victim
and witness units for courts and promoting support for
survivor services, including hotlines and shelters;
``(F) promoting civil remedies in cases of domestic
violence that--
``(i) prioritize victim safety and confidentiality and
offender accountability;
``(ii) grant women and children restraining, protection, or
removal orders with appropriate criminal sanctions for
violations against perpetrators of violence;
``(iii) strengthen and promote women's custodial rights
over children and protect children; and
``(iv) grant courts authority to provide specific relief
pursuant to a restraining or removal order, including
restitution, spousal maintenance, child support, payment of
debt, or return or equitable distribution of property;
``(G) reducing the incidence of violence against women and
girls committed by government officials by developing
confidential mechanisms for reporting violence against women
and girls committed by government officials and institutions
and developing laws to punish the perpetrators and remove
immunity from state officials;
``(H) promoting broader legal protection for women and
girls against all forms of violence against women and girls,
such as female infanticide and female genital mutilation, and
practices that are associated with higher rates of violence
against women and girls, such as child and forced marriage;
and
``(I) increasing the number of women advocates trained to
respond to violence against women and girls at police
stations, including the creation of domestic violence units
and increasing the number of women police.
``(2) Carrying out health care initiatives, including--
``(A) promoting the integration of programs to prevent and
respond to violence against women and girls into existing
programs addressing child survival, women's health, family
planning, mental health, and HIV/AIDS prevention, care, and
treatment;
``(B) training of health care providers, including
traditional birth attendants, on methods to safely and
confidentially assess women and girls seeking health services
for intimate partner, family, and sexual violence;
``(C) developing and enforcing national and operational
women's health, children's health, and HIV/AIDS policies that
prevent and respond to violence against women and girls, with
accompanying resources, including through cooperative efforts
with ministries of health;
``(D) developing information gathering systems within the
health care sector that, consistent with safety and
confidentiality concerns, collect and compile data on the
type of violence experienced by women and girls, access to
care, age of victims, and relationship of victims to
perpetrators;
``(E) working with governments to develop partnerships with
civil society organizations to create referral networks
systems for psychosocial, legal, economic, or other support
services; and
``(F) integrating screening and assessment for gender-based
violence into HIV/AIDS programming and other health
programming into all country operation plans, and increasing
women's access to information, strategies, and services to
protect themselves from HIV/AIDS.
``(3) Conducting public awareness programs to change social
norms and attitudes, including--
``(A) supporting women survivors of violence to educate
their communities on the impacts of violence;
``(B) engaging men, including faith and traditional
leaders;

[[Page S13637]]

``(C) providing funding and programmatic support for mass
media social change campaigns; and
``(D) supporting community efforts to change attitudes
about harmful traditional practices, including child
marriage, female genital mutilation, and so-called `honor
killings'.
``(4) Improving economic opportunities for women and girls,
including--
``(A) supporting programs to help women meet their economic
needs and to increase their economic opportunities, in both
rural and urban areas, including through support for--
``(i) the establishment and development of businesses
(micro, small, and medium-sized enterprises) through access
to financial and nonfinancial services; and
``(ii) education, literacy, and numeracy programs,
leadership development and job skills training, especially in
nontraditional fields and expected growth sectors;
``(B) supporting programs to help increase property rights,
social security, and home ownership and land tenure security
for women by--
``(i) promoting equitable extension of property and
inheritance rights, particularly rights to familial and
marital property;
``(ii) promoting legal literacy, including among faith and
traditional leaders, about women's property rights; and
``(iii) helping women to make land claims and protecting
women's existing claims and advocating for equitable land
titling and registration for women, including safeguards for
women title-holders in the case of domestic violence
disputes;
``(C) integrating activities to prevent and respond to
violence against women and girls into existing economic
opportunity programs by--
``(i) integrating education on violence against women and
girls into women's microfinance, microenterprise, and job
skills training programs; and
``(ii) training providers of economic opportunity services
and programs in sensitivity to violence against women and
girls; and
``(D) addressing violence against women and girls in the
workplace.
``(5) Improving educational opportunities for women and
girls, including--
``(A) supporting efforts and providing resources to provide
training for all teachers and school administrators on
school-related violence, in particular increasing awareness
of violence against women and girls, and to improve
reporting, referral, and implementation of codes of conduct;
``(B) working to ensure the safety of girls during their
travel to and from school and on school grounds;
``(C) including programs for girls and boys on the
unacceptability of violence against women and girls; and
``(D) conducting national and baseline surveys to collect
data on school-related violence against women and girls.

``SEC. 300H. ASSISTANCE TO REDUCE INTERNATIONAL VIOLENCE
AGAINST WOMEN AND GIRLS INTERNATIONALLY.

``(a) Coordinating Existing Aid Programs.--The Coordinator
of the Women's Global Initiatives, working with the Director
of the Office of Women's Global Development, shall ensure
that existing programs, contracts, grants, agreements, and
foreign assistance under the Foreign Assistance Act of 1961
(22 U.S.C. 2166 et seq.), the Migration and Refugee
Assistance Act of 1962 (22 U.S.C. 2601 et seq.), the
Trafficking Victims Protection Act of 2000 (22 U.S.C. 7101 et
seq.), the United States Leadership Against HIV/AIDS,
Tuberculosis and Malaria Act of 2003 (22 U.S.C. 7601 et
seq.), the Support for East European Democracy (SEED) Act of
1989 (22 U.S.C. 5401 et seq.), the FREEDOM Support Act (22
U.S.C. 5851 et seq.), and other Acts authorizing foreign
assistance incorporate, as applicable, measures to prevent
and respond to violence against women and girls.
``(b) Authority.--To implement and execute the
comprehensive international strategy developed pursuant to
section 300G, the President is authorized to provide
assistance to nongovernmental organizations, multilateral
institutions, and foreign countries for program activities
described in section 300G(d).
``(c) Allocate New Funding.--The Coordinator of the Office
of Women's Global Initiatives is authorized to allocate funds
to implement and execute the comprehensive international
strategy developed pursuant to section 300G.
``(d) Use of Funds.--Any funds made available under this
section to nongovernmental organizations must be designated
to organizations that have demonstrated expertise regarding
violence against women and girls internationally, or that are
in partnership with such organizations and that have
demonstrated capabilities or expertise in a particular
program activity described in subsection 300G(d).
``(e) Grants to Women's Nongovernmental Organizations and
Community-Based Organizations.--Not less than 10 percent of
the funds awarded in a fiscal year under this section shall
be awarded to women's nongovernmental organizations and
community-based organizations.
``(f) Award Process.--Funds awarded under this section
shall be provided through an open, competitive, and
transparent process where possible.
``(g) Conditions.--Entities receiving funds awarded through
the grant program established under this section--
``(1) should include the collection of data and the
evaluation of program effectiveness;
``(2) should be responsible for developing and reporting on
outcomes related to preventing and responding to violence
against women and girls;
``(3) should gather input from women's nongovernmental
organizations or community-based organizations, including
organizations with expertise in preventing and responding to
violence against women and girls; and
``(4) shall consider the safety of women and girls as a
primary concern in deciding how to design, implement,
monitor, and evaluate programs.
``(h) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to the Office of Women's Global Initiatives $175,000,000 for
each of the fiscal years 2008 through 2012 to carry out this
section and section 300G.
``(2) Availability of funds.--Amounts appropriated pursuant
to paragraph (1) shall remain available until expended.
``(3) Nonsupplantation.--Funds authorized and appropriated
under this Act shall supplement, not supplant, existing funds
otherwise available for activities under this title.

``SEC. 300I. ANNUAL REPORT ON UNITED STATES EFFORTS TO END
INTERNATIONAL VIOLENCE AGAINST WOMEN AND GIRLS.

``(a) In General.--Not later than 1 year after the
submission of the comprehensive international strategy
developed under section 300G, and annually thereafter, the
Secretary of State, assisted by the Coordinator of Women's
Global Initiatives, shall submit to Congress a report to be
entitled the `Report on International Violence Against Women
and Girls'.
``(b) Content.--The report required under subsection (a)
shall include the following:
``(1) The goals and objectives of the comprehensive
international strategy developed under section 300G(a).
``(2) The specific criteria used to determine the
effectiveness of the strategy.
``(3) A description of the coordination of all United
States Government resources and international activities to
prevent and respond to the problem of violence against women
and girls, including--
``(A) an identification of the Federal agencies involved;
``(B) a description of the coordination between Federal
agencies and departments, including those acting in the
eligible countries; and
``(C) a description of the coordination with non-United
States Government entities, including the governments of
eligible countries, multilateral organizations and
institutions, and nongovernmental organizations.
``(4) A description of the relationship between efforts to
prevent and respond to violence against women and girls
internationally and other United States assistance strategies
in developing countries and diplomatic relationships.
``(5) A description of efforts to include gender-based
violence in United States diplomatic and peacemaking
initiatives.
``(6) A description of any significant efforts by bilateral
and multilateral donors in support of preventing and
responding to international violence against women and girls.
``(7) A description of the implementation of the agency-
specific guidelines described in section 300B(d)(3)(H).
``(8) A description of the activities of, and funding
provided for programs that prevent and respond to violence
against women and girls in humanitarian relief, conflict and
post-conflict operations, including violence perpetrated by
humanitarian workers.
``(9) A description of United States training of foreign
military and police forces, judicial officials, and
humanitarian relief grantees to prevent and respond to
violence against women and girls.
``(10) A description of data collection efforts conducted
under this title.
``(11) Identification of all contractors, subcontractors,
grantees, and subgrantees receiving United States funds for
preventing and responding to violence against women and
girls.
``(12) Recommendations related to best practices, effective
strategies, and suggested improvements to enhance the impact
of efforts to prevent and respond to violence against women
and girls.
``(13) A description of efforts to evaluate the
accountability and efficacy of the programs funded pursuant
to section 300H(g).
``(14) A compilation of the descriptions on the nature and
extent of violence against women and girls included in the
annual Human Rights Reports required under section 116(d) of
the Foreign Assistance Act of 1961, as amended by this Act.
``(15) The identification of countries or regions with
critical outbreaks of violence against women and girls
described in subsection 300L(h), including--
``(A) an analysis of the situations, including the factors
driving the violence, the role of government, militia, rebel,
or other armed forces in the violence; and
``(B) an analysis of United States and other multilateral,
bilateral, or governmental efforts to prevent or respond to
the violence, assist survivors, or hold the perpetrators
accountable.
``(16) A description of United States resources that are
being used--
``(A) to assist in efforts to prevent or respond to the
critical outbreaks of violence described in section 300L(h);
``(B) assist survivors of such violence;

[[Page S13638]]

``(C) hold perpetrators accountable for such violence; and
``(D) encourage all parties to the armed conflict to
protect women and girls from violence.
``(c) Authorization of Appropriations.--There are
authorized to be appropriated to the Secretary of State to
meet the reporting requirements under this section--
``(1) $2,500,000 for fiscal year 2008; and
``(2) $500,000 for each of the fiscal years 2009 through
2012.

``SEC. 300J. DATA COLLECTION.

``(a) In General.--The Coordinator of Women's Global
Initiatives, assisted by the Administrator of the United
States Agency for International Development and the Director
of the Women in Development Office, shall be responsible for
researching, collecting, monitoring, and evaluating data
related to efforts to prevent and respond to violence against
women and girls internationally.
``(b) Use of Funds.--Funds made available under this
section may be used for the following purposes:
``(1) To collect and analyze data on the scope and extent
of all forms of violence against women and girls, including
under-documented forms of violence and violence against
marginalized groups. This work may include original research
or analysis of existing data sets.
``(2) To help governments of countries systematically
collect and analyze data on violence against women and girls,
including both national surveys and data collected by service
providers.
``(3) To use internationally comparable indicators, norms,
and methodologies for measuring the scope, prevalence, and
incidence of violence against women and girls.
``(4) To include data on violence against women and girls
in national and international data collection efforts,
including those administered and funded by the United States
Agency for International Development, the Millennium
Challenge Corporation, and the Centers for Disease Control
and Prevention.
``(c) Authorization of Appropriations.--There is authorized
to be appropriated $20,000,000 for each of the fiscal years
2008 through 2012 to carry out the activities under this
section.

``SEC. 300K. ENHANCING UNITED STATES TRAINING OF FOREIGN
MILITARY AND POLICE FORCES ON VIOLENCE AGAINST
WOMEN AND GIRLS.

``(a) Purpose.--The purpose of this section is to ensure
that United States programs to train foreign military and
police forces and judicial officials include instruction on
preventing and responding to violence against women and girls
internationally.
``(b) Covered Programs.--The programs covered under this
section include--
``(1) activities authorized under the Foreign Assistance
Act of 1961 (22 U.S.C. 2151 et seq.); and
``(2) activities under section 1206 of the National Defense
Authorization Act for Fiscal Year 2006 (Public Law 109-163;
119 Stat. 3456) to build the capacity of foreign military and
police forces to conduct counterterrorist operations or
support military and stability operations in which the United
States is participating.
``(c) Authorization.--The Secretary of State and the
Secretary of Defense, in consultation with the Coordinator of
Women's Global Initiatives, shall--
``(1) incorporate training on how to prevent and respond to
violence against women and girls into the basic training
curricula of foreign military and police forces and judicial
officials; and
``(2) ensure that United States assistance to units
involved in regional or multilateral peacekeeping operations
includes training on preventing and responding to violence
against women and girls internationally.
``(d) Authorization of Appropriations.--There is authorized
to be appropriated $8,000,000 for each of the fiscal years
2008 through 2012 to carry out the activities under this
section.

``SEC. 300L. ADDRESSING VIOLENCE AGAINST WOMEN AND GIRLS IN
HUMANITARIAN RELIEF, PEACEKEEPING, CONFLICT,
AND POST-CONFLICT OPERATIONS.

``(a) Definitions.--In this section, the term `Inter-Agency
Standing Committee' means the committee established in
response to United Nations General Assembly Resolution 46/182
(1991).
``(b) Activities of the Department of State the United
States Agency for International Development.--The Secretary
of State and the Administrator of the United States Agency
for International Development shall--
``(1) in consultation with the Coordinator of Women's
Global Initiatives, provide assistance to programs that
prevent and respond to violence against women and girls in
all humanitarian relief, conflict, and post-conflict
operations, including--
``(A) building the capacity of nongovernmental
organizations to address the special protection needs of
women and children affected by humanitarian, conflict, or
post-conflict operations;
``(B) supporting local and international nongovernmental
initiatives to prevent, detect, and report violence against
women and girls;
``(C) conducting protection and security assessments for
refugees and internally displaced persons in camps or in
communities to improve the design and security of camps, with
special emphasis on the security of women and girls;
``(D) supporting efforts to reintegrate survivors of a
humanitarian relief, conflict, or post-conflict operation
through education, psychosocial assistance, trauma
counseling, family and community reinsertion and
reunification, and medical assistance; and
``(E) providing legal services for women and girls who are
victims of violence during a humanitarian relief, conflict or
post-conflict operation, including the collection of evidence
for war crime tribunals and advocacy for legal reform; and
``(2) require that all grantees deployed in humanitarian
relief, conflict, and post-conflict operations--
``(A) comply with the Inter-Agency Standing Committee's Six
Core Principles Relating to Sexual Exploitation and Abuse;
``(B) train all humanitarian workers in preventing and
responding to violence against women and girls, including in
the use of mechanisms to report violence against women and
girls;
``(C) conduct appropriate public outreach to make known to
the host community the mechanisms to report violence against
women and girls; and
``(D) promptly and appropriately respond to reports of
violence against women and girls and treat survivors in
accordance with best practices regarding confidentiality.
``(c) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to the Department of State and the United States Agency for
International Development $40,000,000 for each of the fiscal
years 2008 through 2010 for programs described in subsection
(b)(1) that prevent and respond to violence against women and
girls in humanitarian relief, conflict, and post-conflict
operations, in addition to amounts otherwise available for
such purposes.
``(2) Funding not at expense of other humanitarian
programs.--Any amounts appropriated pursuant to paragraph (1)
may not be provided at the expense of other humanitarian
programs.
``(d) Activities of the United States Agency for
International Development.--The Administrator of the United
States Agency for International Development, in consultation
with the Coordinator of Women's Global Initiatives, shall
designate and deploy, as appropriate, protection officers as
an integral part of Disaster Assistance Response Teams to
ensure that programs to prevent and address violence against
women and girls are integrated into humanitarian relief,
conflict, and post-conflict operations.
``(e) Activities of the Department of State.--Not later
than 180 days after the date of the enactment of this title,
the Secretary of State shall submit a report to Congress on
efforts to--
``(1) require that all private military contracting firms
hired by the Department of State for humanitarian relief,
conflict, and post-conflict operations--
``(A) demonstrate a commitment to expanding the number and
roles of women in such operations;
``(B) train all contractors who will be deployed to
humanitarian relief, conflict, or post-conflict operations in
preventing and responding to violence against women and
girls. including in the use of mechanisms to report violence
against women and girls;
``(C) conduct appropriate public outreach to make known to
the host community the mechanisms to report violence against
women and girls; and
``(D) promptly and appropriately respond to reports of
violence against women and girls and treat survivors in
accordance with best practices regarding confidentiality; and
``(2) assist women and girls formally involved in, or
associated with, fighting forces as part of any multilateral
or bilateral Disarmament, Demobilization, Rehabilitation and
Reintegration efforts by providing--
``(A) protection and suitable separate facilities for women
and girls in demobilization and transit centers;
``(B) equitable reintegration activities and opportunities
to women and girls, including access to schooling, vocational
training, employment, and childcare; and
``(C) essential medical care and psychosocial support for
women and girls who are victims of gender-based violence.
``(f) Activities of the Department of Defense.--The
Secretary of Defense shall--
``(1) in consultation with the Coordinator of Women's
Global Initiatives and the Director of the Office of Military
Affairs of the Bureau of Democracy, Conflict and Humanitarian
Assistance of the United States Agency for International
Development, provide training in preventing and responding to
violence against civilian women and girls to all United
States military personnel, military contractors, military
observers, and military police forces who will be deployed to
humanitarian relief, conflict, and post-conflict operations;
``(2) in consultation with the Coordinator of Women's
Global Initiatives and the Director of the Office of Military
Affairs of the Bureau of Democracy, Conflict and Humanitarian
Assistance, establish mechanisms for reporting incidences of
violence against civilian women and girls by United States
military personnel, military contractors, military observers,
and police forces participating in humanitarian relief,
peacekeeping, and post-conflict operations; and
``(3) establish appropriate public outreach to notify the
civilian population of the mechanisms for reporting
incidences of violence against civilian women and girls by
United States military personnel, military

[[Page S13639]]

contractors, military observers, and police forces.
``(g) Addressing Violence Against Civilian Women and Girls
by United Nations Peacekeepers.--
``(1) Department of state activities.--The Secretary of
State shall encourage member states of the United Nations--
``(A) to support expanding the number and roles of female
officers in all United Nations peacekeeping missions, whether
as military forces, civilian police, or military observers;
and
``(B) to routinely put forward the names of qualified
female candidates for senior United Nations military and
civilian management positions, particularly for overseas
missions.
``(2) Sense of congress regarding actions of united nations
peacekeepers.--It is the sense of Congress that the
Secretary-General of the United Nations should continue to
strengthen the existing ability of the United Nations
Department of Peacekeeping Operations and the Department of
Field Support to prevent and respond to violence against
women and girls by United Nations military and civilian
personnel by--
``(A) requiring that troop contributing countries properly
train all soldiers on the United Nations guidelines regarding
appropriate conduct towards civilians, in particular those
guidelines that address violence against women and girls,
before participation in United Nations peacekeeping missions;
``(B) supporting the expansion of the role and number of
female officers in all United Nations peacekeeping missions,
whether as military forces, civilian police, or military
observers;
``(C) strongly encouraging all United Nations member states
to routinely put forward the names of qualified female
candidates for senior United Nations military and civilian
management positions, particularly for overseas missions;
``(D) ensuring appropriate mechanisms are in place for
individuals to safely bring allegations of violence against
women and girls to the attention of United Nations
peacekeeping mission commanders and the United Nations Office
of Internal Oversight;
``(E) ensuring the capability and capacity for the United
Nations Office of Internal Oversight to investigate all
credible allegations of violence against women and girls
timely and efficiently, and in a manner that protects the
whistleblower;
``(F) improving informational programs for all United
Nations personnel on their responsibility to prevent violence
against women and girls and not to engage in acts of violence
against women and girls;
``(G) demanding that troop contributing countries--
``(i) thoroughly investigate allegations of their nationals
engaging in violence against women and girls while serving on
United Nations peacekeeping missions; and
``(ii) punish those found guilty of such misconduct; and
``(H) continuing to permanently exclude individuals found
to have engaged in violence against women and girls as well
as troop contingent commanders and civilian managerial
personnel complicit in such behavior, from participating in
future United Nations peacekeeping missions.
``(h) Emergency Measures for Critical Outbreaks of Violence
During Conflict or Post-Conflict Operations.--
``(1) Emergency response to critical outbreaks.--The
Secretary of State, in consultation with the Coordinator of
Women's Global Initiatives, the Director of National
Intelligence, and the Secretary of Defense, shall identify
and take emergency measures to respond to critical outbreaks
of violence against women and girls in situations of armed
conflict when it is determined that the violence is being
used as a weapon of intimidation and abuse.
``(2) Determination.--Violence against women and girls
shall be determined to be a `critical outbreak' if--
``(A) a United States Government report, allied government
information, or credible non-governmental or media accounts
depict a widespread pattern of violence against women or
girls, particularly rape and other forms of sexual abuse,
that is escalating in the number of victims or brutality of
attacks and that takes place in an environment of relative
impunity; or
``(B) escalating violence against women or girls is part of
an organized campaign by governmental or rebel forces or
militias.
``(3) Emergency measures.--Not later than 180 days after
the identification of a critical outbreak, the Secretary of
State, in consultation with the Coordinator of Women's Global
Initiatives, the Director of National Intelligence, and the
Secretary of Defense, shall develop emergency measures to
respond to the outbreak identified under paragraph (1).
``(4) Consultation.--In developing emergency measures under
paragraph (1), the Secretary of State, with the assistance of
the Coordinator, shall consult with--
``(A) nongovernmental organizations with demonstrated
expertise working on preventing and addressing systematic
violence against women and girls as a weapon of intimidation
and abuse in situations of conflict and war; and
``(B) international organizations, such as the United
Nations and its subsidiary funds, agencies, and programs,
which are preventing and addressing systematic violence
against women and girls as a weapon of intimidation and abuse
in situations of conflict and war.
``(5) Content.--The emergency measures developed under
paragraph (1) shall include a description of--
``(A) the bilateral and multilateral diplomatic efforts
that the Secretary of State will take to address the critical
outbreak, including--
``(i) efforts with the government in which the violence is
occurring, governments of the region in which the violence is
occurring, and other allied governments; and
``(ii) efforts in international fora, such as the United
Nations and its subsidiary agencies, funds and programs,
including in the United Nations Security Council, as
appropriate; and
``(B) the efforts by the United States Government to--
``(i) protect women and girls at risk in a critical
outbreak region;
``(ii) urge all parties to the armed conflict to protect
women and girls; and
``(iii) facilitate the prosecution of those responsible for
the violence in a critical outbreak area.
``(6) Notice.--The Secretary of State shall notify Congress
of efforts to respond to critical outbreaks, including a
description of the bilateral and multilateral diplomatic
efforts of the Department of State.
``(i) Authorization of Appropriations.--In addition to
amounts authorized to be appropriated under subsection (c),
there is authorized to be appropriated such sums as may be
necessary for emergency measures, including the expansion of
reporting mechanisms and programs, for each critical outbreak
of violence identified under this section.''.

SEC. 103. INCLUSION OF INFORMATION ON VIOLENCE AGAINST WOMEN
AND GIRLS IN HUMAN RIGHTS REPORTS.

Section 116(d) of the Foreign Assistance Act of 1961 (22
U.S.C. 2151n(d)) is amended--
(1) in paragraph (10), by striking ``; and'' and inserting
a semicolon;
(2) in paragraph (11)(C), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(12) wherever applicable, the nature and extent of
violence against women and girls.''.

TITLE II--OTHER PROVISIONS

SEC. 201. AMENDMENTS TO FOREIGN SERVICE ACT OF 1980.

(a) Performance Pay.--Section 405 of the Foreign Service
Act of 1980 (22 U.S.C. 3965) is amended by adding at the end
the following:
``(f) Promotion of Human Rights.--Service in the promotion
of internationally recognized human rights, including
preventing and responding to violence against women and
girls, shall serve as a basis for the award of performance
pay.''.
(b) Foreign Service Awards.--Section 614 of the Foreign
Service Act of 1980 (22 U.S.C. 4013) is amended by inserting
``and preventing and responding to violence against women and
girls'' after ``religion''.
(c) Foreign Service Training.--Chapter 2 of title I of the
Foreign Service Act of 1980 is amended by adding at the end
the following:

``SEC. 212. TRAINING FOR FOREIGN SERVICE OFFICERS.

``The Secretary of State, assisted by the Coordinator of
Women's Global Initiatives, shall include, as part of the
standard training provided for officers of the Service
(including chiefs of mission), instruction on international
violence against women and girls, including domestic and
sexual violence against women and girls in humanitarian
relief, conflict, and post-conflict operations.''.

SEC. 202. SUPPORT FOR MULTILATERAL EFFORTS TO END VIOLENCE
AGAINST WOMEN AND GIRLS.

There is authorized to be appropriated to the International
Organizations and Programs Account $5,000,000 for each of
fiscal years 2008 through 2012 to support the United Nations
Development Fund for Women Trust Fund in Support of Actions
to Eliminate Violence Against Women.

Section-by-Section Summary of the International Violence Against Women
Act of 2007

Sec. 1. Short Title.
Sec. 2. Table of Contents.
Sec. 3. Findings.--This section details the magnitude of
the problem of violence against women and girls in families,
communities, and countries around the world.
Sec. 4. Statement of Policy.--This section states that it
is U.S. policy to promote women's political, economic,
educational, social, cultural, civil, and human rights and
opportunities throughout the world and to prevent and respond
to violence against women and girls.
Sec. 5. Definitions.--This section defines ``violence
against women as ``any act of gender-based violence against
women or girls committed because of their gender that results
in, or is likely to result in, physical, sexual, or
psychological harm or suffering to women, including threats
of such acts, coercion, or arbitrary deprivations of liberty,
whether occurring in public or private life.'' (Identical to
the widely-used, internationally-accepted definition.)

Title I: Coordination and Policy Planning

Sec. 101. Official Positions and Institutional Changes.--
This section amends chapter 2, part I of the Foreign
Assistance Act of 1961 (22 U.S.C. 2166 et seq) by adding the
following new title: ``Title XIII--International

[[Page S13640]]

Prevention of Violence Against Women and Girls''.
Sec. 300A. Violence Against Women and Girls Defined.--
``Violence against women'' is defined in section 5 of the
International Violence Against Women Act of 2007.

Subtitle A--Official Positions and Institutional Changes

Sec. 300B. Office of Women's Global Initiatives.--This
section establishes an ``Office of Women's Global
Initiatives'' in the immediate office of the Secretary of
State. The Coordinator of the Office of Women's Global
Initiatives (the ``Coordinator'') will be appointed by the
President with the advice and consent of the Senate and with
the rank and status of Ambassador at Large. The Coordinator
will design, oversee, and coordinate activities of the U.S.
Government related to international women's issues, including
violence against women and girls, and will develop the
comprehensive international strategy as provided in this
bill. The Coordinator will integrate efforts to reduce
violence against women into existing U.S. Government
assistance programs; allocate new funding to new programs;
design, integrate, and implement new programs; and monitor
and evaluate all programs. This section authorizes the
appropriation of $15,000,000 for each of the fiscal years
2008-2012 to perform these office functions.
Sec. 300C. Women's Global Development Office.--This section
establishes the Office of Women's Global Development within
the United States Agency for International Development
(USAID). The head of the office will be the Director of
Women's Global Development (the ``Director''), who will be
appointed by the President with the advice and consent of the
Senate and will report directly to the Administrator. The
Director will consult regularly with the Coordinator of the
Office of Women's Global Initiatives. The Director will
integrate gender into USAID programs and activities and will
ensure that efforts to prevent and respond to violence
against women and girls are integrated into U.S. Government
assistance programs. This section authorizes the
appropriation of $15,000,000 for each of the fiscal years
2008-2012 to perform these office functions.
Sec. 300D. Advisory Commission on International Violence
Against Women and Girls.--This section establishes an
Advisory Commission on International Violence Against Women
in the Department of State. The Advisory Commission will be
composed of the Coordinator of Women's Global Initiatives,
the Director of the Women's Global Development Office, eight
members appointed by the President, three members appointed
by the President pro tempore of the Senate, and three members
appointed by the Speaker of the House of Representatives.
Members will have expertise in the issue of violence against
women and girls internationally and will include
representatives of nongovernmental organizations (NGOs), and
academics. This section authorizes the appropriation of
$300,000 for each of fiscal years 2008-2012 to carry out the
Commission's activities.
Sec. 102. Policy and Programs.--This section adds the new
subtitle: ``Subtitle B--Policy and Programs''.
Sec. 300G. Comprehensive International Strategy to Reduce
and Prevent Violence Against Women and Girls.--This section
mandates the President, with the assistance of the
Coordinator of Women's Global Initiatives and the Director of
the Women's Global Development Office, within one year of the
enactment of the Act, to submit to Congress a 5-year,
comprehensive strategy to combat violence against women
internationally.
The strategy will identify 10-20 low to middle income
countries that have severe levels of gender-based violence.
The strategy will describe the violence problems in each
country and how the domestic and/or sexual violence is
preventing sustainable progress in meeting humanitarian and/
or development goals. The strategy will assess each country's
capacity for change and the necessary collaboration. For each
country, the strategy will describe two or more new programs
that will be implemented to address the gender-based
violence. The strategy will explain the coordination with
existing country programs, experts and organizations and will
identify what U.S. government agencies will be involved for
each country initiative. Finally, the strategy mandates
monitoring, assessment and accountability mechanisms for each
country's programs.
As mentioned, the strategy will designate two or more
programs to be implemented in each of the selected countries.
This section sets forth a menu of possible, new gender-
based violence program activities within five different
sectors--legal reform and judicial protection, health care
initiatives, public awareness campaigns, economic
improvements and increasing educational opportunities.
Sec. 300H. Assistance to Reduce Violence Against Women and
Girls Internationally.--This section authorizes the
Coordinator to incorporate measures combating violence
against women into existing acts and government legislation.
It gives the Coordinator authority to provide annually $175
million of new funding to federal agencies, NGOs, community-
based organizations, foreign governments, and multilateral
institutions seeking to prevent and to reduce violence
against women through the activities described in the
international strategy.
Sec. 300I. Annual Report on International Violence Against
Women and Girls.--This section determines that, not more than
one year after the enactment of this Act, the Secretary, with
the assistance of the Coordinator and the Director, will
submit an annual report to Congress on the U.S. progress to
end international violence against women and girls. The
report will incorporate the comprehensive international
strategy and detail the progress of the grant programs, the
collaboration with multinational organizations, the training
administered to humanitarian and military forces on gender-
based violence, and the status of best practices developed to
address the violence. This section authorizes the
appropriation of $2,500,000 for the year 2008 and $500,000
for each of fiscal years 2009-2012 to generate the report.
Sec. 300J. Data Collection, Research, Monitoring, and
Evaluation.--This section states that the Coordinator, with
the assistance of the Administrator of USAID and the Director
of the Women's Global Development Office, is responsible for
researching, collecting, monitoring, and evaluating data on
the effectiveness of programs designed as part of the global
strategy to address violence against women and girls. Funds
will be used to conduct national surveys and original
research, and to monitor the effectiveness of new and
existing programs. This section authorizes the appropriation
of $20,000,000 to carry out the activities listed.
Sec. 300K. Enhancing United States Training of Foreign
Military and Police Forces on Violence Against Women and
Girls.--This section mandates that the Secretary of State and
the Secretary of Defense report to Congress on efforts to
incorporate instruction on preventing and responding to
violence against women and girls in all basic training
curricula of foreign military and police forces and judicial
officials, and that such training shall be a component of all
U.S. assistance to regional or multilateral peacekeeping
units. Under this section, $8,000,000 is authorized for each
of fiscal years 2008-2012 to carry out such training
activities.
Sec. 300L. Addressing Violence Against Women and Girls in
Humanitarian Relief, Peacekeeping, Conflict, and Post-
Conflict Operations.--This section increases the ability of
the United States Agency for International Development, the
Department of State and the Department of Defense to prevent
and address violence against women and girls in humanitarian
relief, peacekeeping, conflict and post-conflict operations.
Programs and grantee training.--Under this section, the
Secretary of State and Administrator of USAID shall include
programs to prevent and respond to violence against women and
girls in all humanitarian relief, conflict, and post-conflict
operations under their authority. There is authorized to be
appropriated $40,000,000 for each of fiscal years 2008-2012
to carry out such activities.
The Secretary of State and Administrator of USAID shall
also require that all grantees that are deployed in such
operations comply with the Inter-Agency Standing Committee
Guidelines for Gender-Based Violence, and train all
humanitarian workers in preventing and responding to violence
against women and girls. Such training shall include the use
of mechanisms to report violence against women and girls.
Grantees shall be required to conduct public outreach
campaigns to make known to the host community the mechanisms
to report incidents of violence against women and girls,
promptly respond to reports of such violence, and treat
survivors confidentially.
Disaster Assistance Response Teams (DARTS).--This section
also mandates that the Administrator of USAID deploy, as
appropriate, protection officers as part of Disaster
Assistance Response Teams (DART) to implement programs to
prevent and address violence against women and girls.
State Department Report on Private Military Contractors and
DDR efforts.--Under this section, the Secretary of State is
required to submit a report outlining the Department's
efforts to require that all private military contracting
firms hired for humanitarian relief, conflict, and post-
conflict operations demonstrate a commitment to expanding the
number and role of women, and train all contractors in
preventing and responding to violence against women and
girls, including in the use of mechanisms to report such
violence.
The report shall also include information on the
Department's efforts to establish programs to assist women
and girls as part of any multilateral or bilateral
Disarmament, Demobilization, Rehabilitation and Reintegration
[DDRR] programs.
Emergency Measures to respond to violence in Armed
Conflict.--This section requires the Secretary of State to
take emergency measures to identify and respond to ``critical
outbreaks'' of violence against women and girls being used as
a weapon of intimidation and abuse in situations of conflict
and war, and shall notify Congress with a description,
including bilateral and multilateral efforts with the
government in which the violence is occurring, and
governments of the surrounding region.
Department of Defense Training.--This section requires the
Secretary of Defense to provide training in preventing and
responding to violence against civilian women and girls to
all United States military personnel and contractors who will
be deployed to humanitarian relief, conflict, and post-
conflict operations. The training must include mechanisms for
reporting incidences of violence, as well as public outreach
to make known to the civilian population the mechanisms.

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Sense of the Senate Concerning U.N. Peacekeepers.--This
section expresses the Sense of the Senate that the UN
Secretary General should strengthen the United Nations'
capability to prevent and respond to violence against
civilian women and girls by United Nations Peacekeepers.
Sec. 104. Inclusion of Information on Violence Against
Women and Girls in Human Rights Reports.--This section amends
Section 116(d) of the Foreign Assistance Act of 1961 (22
U.S.C. 2151n) to include a description of the nature and
extent of violence against women in the Department of State's
annual Human Rights Report.

Title II: Other Provisions

Sec. 201. Amendments to Foreign Service Act of 1980.--This
section amends Section 405 of the Foreign Service Act of 1980
(22 U.S.C. 3965) to provide that service in the promotion of
human rights, including the rights of women and girls, will
serve as a basis for performance pay.
Sec. 212. Training for Foreign Service Officers.--This
section amends Chapter 2 of title I of the Foreign Service
Act of 1980 to provide for training for foreign service
officers on international violence against women.
Sec. 202. Support For Multilateral Efforts to End Violence
Against Women and Girls.--This section authorizes the
appropriation of $5,000,000 for each of fiscal years 2008-
2012 to the United Nations Development Fund for Women
(UNIFEM) Trust Fund in Support of Actions to Eliminate
Violence Against Women.

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